21st Meeting on Cancer Care Delivery Systems
Overview
The 21st meeting discussed draft revisions to designation requirements for three systems—adult cancer care, pediatric cancer care, and cancer genomic medicine—based on plans to build a cancer care delivery system looking toward 2040 and the interim evaluation of the Fourth Basic Plan for Promotion of Cancer Control. For adult care, the meeting considered reporting and publication of treatment outcomes, the centralization of surgery and radiotherapy, and the delivery system for cancer genomic medicine. For pediatric care, it presented measures to centralize hub hospitals, establish prefectural pediatric cancer hub hospitals, and address drug lags and drug losses. For cancer genomic medicine, it outlined the development of prefectural hubs, expansion of eligible cooperating hospitals, and the role of core hubs in international joint clinical trials and workforce development. The overall direction of the three development guidelines was broadly approved, and the drafts were placed under the chair’s supervision for final adjustments reflecting the opinions expressed before proceeding with publication procedures.
Key points
- Looking toward 2040, a direction was presented to reflect both the equalization and centralization of cancer care in revisions to the development guidelines.
- Draft outlines for revising designation requirements were presented for three systems: adult cancer care, pediatric cancer care, and cancer genomic medicine.
- Centralization of pediatric cancer hub hospitals from 15 locations to approximately 10 locations was proposed.
- The three draft development guidelines were placed under the chair’s supervision, with a policy of proceeding to publication procedures after final adjustments.
Overview
The 21st Meeting on Cancer Care Delivery Systems discussed the following agenda items: revisions to the designation requirements for cancer care collaboration hub hospitals and other institutions; revisions to the designation requirements for pediatric cancer hub hospitals and other institutions; and revisions to the designation requirements for core cancer genomic medicine hospitals and other institutions. The review focused on a sustainable cancer care delivery system looking toward 2040 and the interim evaluation of the Fourth Basic Plan for Promotion of Cancer Control.
For adult care, a concept was presented to consider centralizing surgery, radiotherapy, and other services in light of changes in medical demand, technology, and human resources, while using equal access to high-quality care nationwide as the foundation. For pediatric care, a direction was presented that would combine the centralization of specialized care with prefecture-level care and long-term follow-up systems.
For cancer genomic medicine, a concept was presented to clarify the roles of prefectural hubs and cooperating hospitals, with core hospitals responsible for research and development, workforce development, and international joint clinical trials.
Impact
The overall direction of the three development guidelines was broadly approved. The drafts were placed under the chair’s supervision, and the secretariat and chair will incorporate the opinions expressed, make final adjustments, and proceed with procedures for publication.
A policy was presented to continuously monitor and analyze adult care equalization and centralization, pediatric cancer delivery systems and long-term follow-up, and the operation of collaborative groups for cancer genomic medicine, in preparation for the fiscal 2029 revision.
Details
Under the draft revisions for adult care, the meeting will consider making at least 400 surgeries annually and at least 200 radiotherapy cases annually mandatory requirements for regional cancer care collaboration hub hospitals at the fiscal 2029 revision. A direction was presented to avoid substituting coverage rates, track the number of surgeries, surgical staffing, radiotherapy equipment, patient numbers, and specialist staffing in current-status reports, and publish treatment outcomes.
Of the 357 regional cancer care collaboration hub hospitals, 237 are classified as core cancer genomic medicine hospitals or other designated institutions, while 2 of the 59 regional cancer care hospitals are cooperating hospitals for cancer genomic medicine. A draft was presented to make designation a desirable requirement in fiscal 2026 and a mandatory requirement in fiscal 2029.
For pediatric cancer, a draft was presented to establish, in principle, one prefectural pediatric cancer hub hospital based on prefectural recommendations and assign it responsibility for coordination of standard treatment, workforce development, hospital cancer registries, and long-term follow-up. Pediatric cancer hub hospitals will provide advanced specialized care, multidisciplinary treatment, and participation in clinical trials.
The number of pediatric cancer cases was estimated to reach 1,589 in 2040, a 15% decrease from 1,865 in 2025. As measures against drug lags and drug losses, a framework was explained under which the government determines the need for pharmaceutical products whose domestic development has not begun and requests development from companies or publicly solicits development companies.
For cancer genomic medicine, a draft was presented to designate, in principle, one cancer genomic medicine hub hospital based on recommendations from each prefecture and assign it responsibility for securing the delivery system within the prefecture and resolving regional issues. Cooperating hospitals may be designated from among hospitals meeting the requirements, and expert panel coordination groups may be formed across prefectural boundaries.
Based on the interim evaluation of the Fourth Basic Plan for Promotion of Cancer Control, a direction was presented to reflect second opinions, supportive care, cancer consultation and support centers, appearance care, specialized personnel placement, and long-term follow-up in the development guidelines as necessary.