ArticleInternational journal of clinical oncology2026
Facility-level JSMO specialist availability and reconstructable treatment-process measures in colorectal cancer using C-CAT data.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundC-CAT lacks patient-level data on Japanese Society of Medical Oncology (JSMO) specialist involvement. We assessed facility-level registry-listed JSMO specialist availability and C-CAT-reconstructable treatment-process and endpoint-ascertainment measures in colorectal cancer.
methodsThis nationwide retrospective C-CAT facility-level analysis included 11,906 patients at 261 facilities. The primary exposure was facility-level JSMO specialist count (0-3 vs 4 +); the secondary exposure was gastrointestinal-domain JSMO specialist presence. The primary endpoint was time from systemic therapy start to recorded second-line treatment end. Facility-cluster robust Cox models were used. Endpoint ascertainment, missingness-focused sensitivity analyses, and overall survival (OS) were supportive/contextual.
resultsOverall, 5349 patients at 181 facilities were in the 0-3 group and 6557 patients at 80 facilities in the 4 + group. Median time to recorded second-line treatment end was 20.2 versus 23.1 months (log-rank p < 0.001). In facility-cluster robust Cox models, the unadjusted HR for 4 + versus 0-3 specialists was 0.840 (95% CI 0.761-0.927; p < 0.001), attenuating after facility-category adjustment (HR, 0.948; 95% CI 0.853-1.055; p = 0.329) and clinical adjustment (HR, 0.968; 95% CI 0.866-1.082; p = 0.565). Second-line end-date availability was lower in the 4 + group (61.6% vs 69.1%). Supportive OS showed no specialist-associated survival advantage (median, 50.2 vs 51.3 months; clinically adjusted HR, 0.962; 95% CI 0.816-1.135; p = 0.648).
conclusionsC-CAT can reconstruct facility-level treatment-process and endpoint-ascertainment measures, but current C-CAT data do not support specialist-attributable clinical interpretation. Direct evaluation requires chemotherapy-specific national database elements.
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