Regional differences in perceptions of cancer care centralisation in Japan: A patient advocate survey

Japan is promoting specialised cancer care centralisation by 2040. However, patients' and citizens' perceptions of these changes remain unclear. This study examined perceptions, concerns, and support needs regarding equity in Japan's cancer care centralisation.

The National Cancer Center Japan's Patient and Public Panel members participated in a cross-sectional, web-based survey. Of 99 members, 73 responded (73.7%) and were categorised into rural (population <200,000) and non-rural groups. Perceived cancer care availability, care access difficulty, importance of hospital information, preferred information channels, and support measure importance were assessed using five-point Likert scales. Group differences were examined using nonparametric tests.

Core cancer treatments were generally available, whereas home care, rehabilitation, and supportive care were less available. Rural participants reported significantly lower availability of multiple services and greater difficulty accessing specialists, supportive care, rehabilitation, medications, psychological support, and transportation. They also assigned lower importance to society-certified facilities, consultation support, and second opinions. No regional differences were observed in information media; both groups favoured hospital-based explanations and the National Cancer Center Japan. Participants rated various support measures-particularly cancer care information, hospital collaboration, and Cancer Information and Support Centres (CISC)-as highly important.

Perceived cancer care availability and accessibility differ regionally. However, all participants considered comprehensive support measures important for centralisation. Incorporating patient and public perspectives is important for designing equitable, acceptable cancer care policies toward 2040.

This study demonstrates that integrating patient and public perspectives into policy development is essential for building a sustainable, acceptable cancer care delivery system by 2040.