Aim To identify groups of nurses engaging in coronavirus disease (COVID-19) care who are most in need of organizational support. Background Overwhelming stress and susceptibility to burnout have been reported in nurses during the COVID-19 pandemic. Methods Nurses working at five hospitals that accepted COVID-19 patients answered the questionnaire. The Tokyo Metropolitan Distress Scale for Pandemic, Self-Diagnosis Check List for Assessment of Workers' Accumulated Fatigue and Japanese Burnout Scale were evaluated. Multiple regression analysis was performed to examine the relationship between engaging in COVID-19 care and psychosocial/physical burden. Results In total, 895 questionnaires were analysed. With experience in caring for COVID-19 patients as the independent variable, nurses caring for suspected cases had significantly higher standardized Tokyo Metropolitan Distress Scale for Pandemic scores for 'concerns for infection' (standardized partial regression coefficient beta = .921, P = .004), Assessment of Workers' Accumulated Fatigue (beta = .445, P = .022) and Japanese Burnout Scale 'emotional exhaustion' (beta = .136, P = .021) than those caring for confirmed cases. Conclusions Nurses caring for suspected COVID-19 patients have the highest psychological/physical burden and propensity for burnout. Implications for Nursing Management Extensive support systems are required for nurses caring for confirmed and suspected COVID-19 cases.

Interventions for residents and medical/financial resources available to screening providers can improve cancer screening rates. Yet the mechanisms by which the interactions of these factors affect the screening rates remain unknown. This study employed structural equation modeling to analyze the mechanisms underlying these factors. Data for Japanese municipalities’ medical/financial status, their implementation of screening interventions, and the number of municipality-based cancer screening appointments from April 2016 to March 2017 were obtained from an open database. Five cancer screenings were included: gastric, lung, colorectal, breast, and cervical cancer screening; all are nationally recommended for population screening in Japan. We defined two latent variables, namely, intervention for residents and medical/financial resources, and then analyzed the relationships between these variables and screening rates using structural equation modeling. Models were constructed for gastric, lung, and breast cancer screening, and similar relationships were observed. With these cancer types, medical/financial resources affected the intervention for residents, directly affecting screening rates. One limitation of this study is that it only included screening by municipalities, which may cause selection bias. In conclusion, financial pressures and lack of medical resources may cause a reduction in screening intervention programs, leading to stagnant screening rates. Ensuring consistent implementation of interventions for residents may improve local and regional cancer screening rates.

Suicide risk in cancer patients peaks early post-diagnosis; however, detailed studies on its changes are scarce. We analyzed population-based cancer registry data to identify trends in suicide risk and incidence following diagnosis among cancer patients. Data of cancer patients who died between 2016 and 2018 were used for descriptive analysis, while data of patients who were newly diagnosed during the same period were used to calculate standardized mortality ratios (SMRs) and conduct survival and multivariable analyses. The diagnostic data included follow-up information through the end of 2019. All data were obtained from the Kanagawa Cancer Registry. The SMRs for suicide were calculated every 3 months up to 48 months post-diagnosis. Cumulative incidences of suicide were calculated using survival analysis. Risk factors associated with suicide were identified with multivariable analysis using the Fine and Gray method. Among the 105 598 cancer patients who died during the study period, 282 patients (0.27%) died by suicide. The SMRs of suicides were 2.71 (95% confidence interval [CI]: 1.99–3.60) and 2.10 (95% CI: 1.64–2.66) up to 6 months and 1 year post-diagnosis, respectively. The maximum change in the 3-month interval SMR was 3.45 (95% CI: 2.34–4.89) within the first 3 months, subsequently decreasing to the same level as that of the general population and temporarily increasing again in 13–15 months. In the survival analysis, the cumulative suicide rates at 6 and 12 months were 0.23% and 0.33%, respectively. In the multivariate analysis, suicide risk was significantly higher in patients with intermediate or poor prognosis cancer sites and lower in females. Suicide among cancer patients is a rare event in the aggregate, but it still occurs in small numbers and should be addressed. The bimodal increase in SMR suggests the influence of adverse outcomes, such as cancer diagnosis, recurrence, and metastasis.

Background: We aimed at assessing 15-year trends in 5-year net survival for men diagnosed with prostate cancer during 2000–2014 and registered by 16 Japanese regional population-based cancer registries included in the CONCORD-3 study. Methods: We included data on adult men (15–99 years) diagnosed with prostate cancer during 2000–2014 and followed-up to 31 December 2014. We grouped patients into five age groups (15–54, 55–64, 65–74, 75–84, and 85–99 years) and four morphology groups according to the ICD-O-3 classification (epithelial, neuroendocrine, other specified morphologies, and malignant neoplasm, not otherwise specified). We grouped patients by stage at diagnosis into localized, regional, and advanced disease. We estimated 5-year net survival by age group, morphological subtype and stage using the Pohar Perme estimator, correcting for background mortality. All-ages estimates were standardized with the International Cancer Survival Standard weights. Results: Age-standardized 5-year net survival increased over time, from 85.9% in 2000–2004 to 93.0% in 2010–2014. Survival was higher than 90% for epithelial tumors, and for localized and regional disease. Five-year net survival for patients with distant metastasis was poor at 47.3% (95% CI. 39.4–55.1%) during 2010–2014. Conclusions: The improvement in survival for prostate cancer may be due to the high and increasing proportion of patients with localized disease and with epithelial tumors, for which 5-year survival approaches 100%. A comprehensive analysis of long-term survival over a longer period of time would be essential to investigate further the factors contributing to the increasing trend in survival.

Background: We estimated net survival trends for patients with stomach cancer registered in 16 regional population-based cancer registries in Japan that participated in the CONCORD-3 study. Methods: We included data on adults (15–99 years) diagnosed with stomach cancer between 2000 and 2014 and followed-up for their vital status until 31 December 2014. We grouped cancer patients into three anatomic groups (proximal, distal, and overlapping regions and stomach cancer, not otherwise specified) with the International Classification of Disease for Oncology, Third edition topography codes. We estimated 5-year net survival with the Pohar Perme estimator for three calendar periods (2000–2004, 2005–2009, 2010–2014), by age group (15–44, 45–54, 55–64, 65–74, and 75–99 years), anatomic group, and stage at diagnosis. All-ages survival estimates were age-standardized using the International Cancer Survival Standard weights. Results: Five-year net survival improved over time, from 50.5% in 2000–2004 to 57.6% and 60.3% in 2005–2009 and 2010–2014, respectively. Survival for patients with proximal stomach cancer improved from 49.7% in 2000–2004 to 53.5% 2005–2009 and plateaued to 53.1% in 2010–2014. Survival for distal stomach cancer increased from 64.8% in 2000–2004 to 67.6% and 68.2% in 2005–2009 and 2010–2014, respectively. In 2010–2014, 5-year net survival for patients with localized disease (94.8%) was much higher than survival for regional (53.7%) and distant (6.4%) disease. Conclusions: Five-year net survival for stomach cancer improved noticeably during 2000–2014. This improvement might be due to advances in systemic chemotherapy. Although survival in distal stomach cancer had improved, no such improvement was seen in proximal stomach cancer. Standardizing esophagogastric junction cancer treatment may improve its outcomes and contribute to better survival in proximal stomach cancer overall. Scientific evaluation of screening programs is also needed to enhance the efficacy of stomach cancer control initiatives in Japan.