BACKGROUND Palliative care (PC) is increasingly recognized as essential for oncology care, and several academic societies strongly recommend integrating oncology and palliative care (IOP) in daily practice. Similarly, the Japanese government encouraged the implementation of IOP through the Cancer Control Act of 2007; however, its detailed progress remains unclear. Therefore, this cross-sectional nationwide survey was conducted to investigate the current status and hospital executive physicians' perception of IOP. METHODS The questionnaire was developed based on IOP indicators with international consensus. It was distributed to executive physicians at all government-designated cancer hospitals (DCHs, n = 399) and matched non-DCHs (n = 478) in November 2017 and the results were compared. RESULTS In total, 269 (67.4%) DCHs and 259 (54.2%) non-DCHs responded. The number of PC resources in DCHs was significantly higher than those in non-DCHs (e.g., full-time PC physicians and nurses, 52.8% vs. 14.0%, p < 0.001; availability of outpatient PC service ≥3 days per week, 47.6% vs. 20.7%, p < 0.001). Routine symptom screening was more frequently performed in DCHs than in non-DCHs (65.1% vs. 34.7%, p < 0.001). Automatic trigger for PC referral availability was limited (e.g., referral using time trigger, 14.9% vs. 15.3%, p = 0.700). Education and research opportunities were seriously limited in both types of hospitals. Most executive physicians regarded IOP as beneficial for their patients (95.9% vs. 94.7%, p = 0.163) and were willing to facilitate an early referral to PC services (54.7% vs. 60.0%, p < 0.569); however, the majority faced challenges to increase the number of full-time PC staff, and < 30% were planning to increase the staff members. CONCLUSIONS This survey highlighted a considerable number of IOP indicators met, particularly in DCHs probably due to the government policy. Further efforts are needed to address the serious research/educational gaps.

中文翻译：

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日本将肿瘤学和姑息治疗相结合的现状：一项全国性调查。

背景技术姑息治疗（PC）日益被认为是肿瘤学治疗必不可少的，并且一些学术团体强烈建议将肿瘤学和姑息治疗（IOP）整合到日常实践中。同样，日本政府通过2007年《癌症控制法》鼓励实施IOP。但是，其详细进展仍不清楚。因此，本次全国性横断面调查旨在调查当前状况以及医院执行医师对眼压的看法。方法采用国际共识的眼压指标制定问卷。它于2017年11月分发给所有政府指定的癌症医院（DCH，n = 399）和匹配的非DCH（n = 478）的执行医师，并对结果进行了比较。结果总共有269个（67.4％）DCH和259个（54。2％）的非DCH做出了回应。DCH的PC资源数量显着高于非DCH的PC资源数量（例如，专职PC医师和护士，分别为52.8％和14.0％，p <0.001；每周可提供≥3天的门诊PC服务，为47.6） ％vs. 20.7％，p <0.001）。与非DCH相比，在DCH中进行常规症状筛查的频率更高（65.1％vs. 34.7％，p <0.001）。PC引用可用性的自动触发受到限制（例如，使用时间触发的引用，分别为14.9％与15.3％，p = 0.700）。两种医院的教育和研究机会都受到严重限制。大多数执行医师认为眼压对患者有益（95.9％vs. 94.7％，p = 0.163），并愿意促进早期转诊PC服务（54.7％vs. 60.0％，p <0.569）；然而，大多数人面临增加专职PC员工数量的挑战，而少于30％的人计划增加员工数量。结论本次调查强调了相当数量的IOP指标得到满足，尤其是在DCH中，可能是由于政府政策的影响。需要进一步努力解决严重的研究/教育空白。