scholarly journals Clinical Utility of Next-Generation Sequencing-Based Panel Testing under the Universal Health-Care System in Japan: A Retrospective Analysis at a Single University Hospital

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1121
Author(s):  
Chiaki Inagaki ◽  
Daichi Maeda ◽  
Kazue Hatake ◽  
Yuki Sato ◽  
Kae Hashimoto ◽  
...  

Next-generation sequencing (NGS) assay is part of routine care in Japan owing to its reimbursement by Japan’s universal health-care system; however, reimbursement is limited to patients who finished standard treatment. We retrospectively investigated 221 patients who underwent Foundation One CDX (F1CDx) at our hospital. Every F1CDx result was assessed at the molecular tumor board (MTB) for treatment recommendation. Based on patients’ preferences, presumed germline findings were also assessed at the MTB and disclosed at the clinic. In total, 204 patients underwent F1CDx and 195 patients completed the analysis; however, 13.8% of them could not receive the report due to disease progression. Among 168 patients who received the results, 41.6% had at least one actionable alteration, and 3.6% received genomically matched treatment. Presumed germline findings were nominated in 24 patients, and 16.7% of them contacted a geneticist counselor. The NGS assay should be performed earlier in the clinical course to maximize the clinical benefit. Broader reimbursement for the NGS assay would enhance the delivery of precision oncology to patients. Access to clinical trials affects the number of patients who benefit from NGS. Additionally, the disclosure of presumed germline findings is feasible in clinical practice.

HPB ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 319-327 ◽  
Author(s):  
Linn S. Nymo ◽  
Kjetil Søreide ◽  
Dyre Kleive ◽  
Frank Olsen ◽  
Kristoffer Lassen

Cancer ◽  
2020 ◽  
Vol 126 (20) ◽  
pp. 4545-4552
Author(s):  
Laura E. Davis ◽  
Natalie G. Coburn ◽  
Julie Hallet ◽  
Craig C. Earle ◽  
Ying Liu ◽  
...  

2018 ◽  
Vol 160 (3) ◽  
pp. 488-493 ◽  
Author(s):  
Diana Khalil ◽  
Martin J. Corsten ◽  
Margaret Holland ◽  
Adele Balram ◽  
James Ted McDonald ◽  
...  

Objective Diagnosis of laryngeal cancer is dependent on awareness that persistent hoarseness needs to be investigated as well as access to an otolaryngologist. This study aimed to better classify and understand 3 factors that may lead to variability in stage at presentation of laryngeal cancer: (1) socioeconomic status (SES), (2) differences in access to health care by location of residence (rural vs urban or by province), and (3) access to an otolaryngologist (by otolaryngologists per capita). Study Design Registry-based multicenter cohort analysis. Setting This was a national study across Canada, a country with a single-payer, universal health care system. Subjects All persons 18 years or older who were diagnosed with laryngeal cancer from 2005 to 2013 inclusive were extracted from the Canadian Cancer Registry (CCR). Methods Ordered logistic regression was used to determine the effect of income, age, sex, province of residence, and rural vs urban residence on stage at presentation. Results A total of 1550 cases were included (1280 males and 265 females). The stage at presentation was earlier in the highest income quintile (quintile 5) compared to the lower income quintiles (quintiles 1-4) (odds ratio [OR], 0.68; P < .05). There was a statistically significant difference in stage at presentation based on rural or urban residence within the highest income quintile (OR, 1.73; P < .005). Conclusion There is a relationship between SES and stage at presentation for laryngeal cancer even in the Canadian universal health care system.


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