"Integrated Cancer Clinical Database" of the Japanese Foundation for Cancer Research — Three institutions participate in research and development and start social implementation.

On November 26, 2024, the Cancer Institute Hospital of the Japanese Foundation for Cancer Research (JFCR) (Hospital Director Takeshi Sano) announced that Aichi Cancer Center (Hospital Director Kazuhito Yamamoto), Shizuoka Cancer Center (Hospital Director Hiroyuki Ono), and Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital (Director Masakazu Toi), as joint research and development organizations, joined the "Integrated Cancer Clinical Database" project. This project is being conducted under the Cabinet Office SIP "Construction of Integrated Healthcare System." The project aims to build a medical information infrastructure that supports an autonomous cycle of "knowledge discovery" and "provision of high-quality medical care" in the field of cancer. The database system originally developed by the Cancer Institute Hospital of JFCR was reworked into a generalized product package system through the SIP research and development project. The three participating institutions will be its initial users.

Since 2017, the Cancer Institute Hospital of JFCR has independently developed the "Integrated Cancer Clinical Database." The aim was to build a centralized management system that automatically or semi-automatically integrates cancer care information that is spread across electronic medical records and various databases in different departments. The system was designed to establish an IT infrastructure that links clinical practice and research, providing a foundation for utilizing clinical data on 9,000 cancer cases per year in future clinical practice and medical research.

The Cancer Institute Hospital of JFCR is already using this system. The system registers respiratory, breast, and thyroid surgery cases for NCD projects. Furthermore, the system has brought about a substantial decrease in work time and a major improvement in work efficiency, eliminating the risk of transcription errors and improving the safety of data management. In the past, each department had to create databases from electronic medical records and perform administrative work for case reporting for clinical research on a department-by-department basis.

Since fiscal year 2003, Cancer Institute Hospital of JFCR has collaborated with core cancer centers on the construction and social implementation of a "multicenter integrated cancer clinical database" under subproject B-1 of the SIP Phase 3 "Construction of Integrated Healthcare System" toward collaboration with the pharmaceutical industry to solve drug lag and drug loss as well as to manage data within hospitals. Since the database will be linked to the database of each institution, more clinical data will be accumulated as the number of institutions adopting the database increases.

The application implemented in the system allows for data searches, which not only facilitate the management of the number of cases of different diseases but are also expected to promote the development of treatments, drugs, and medical devices by utilizing clinical data. The foundation for a medical interview system that operates as a smartphone application has also been developed through the same research and development project. Patients can electronically complete the medical interview process, which used to require patients to fill out paper-based questionnaire forms at the time of visits. Once the completed patients' data are read by the facility's 2D barcode reader at the time of their visit, the contents are recorded in a database and automatically entered into the electronic medical record. Doctors are able to assess the patient's condition before examination. Moving forward, the hospital is considering liking it with various existing services, taking advantage of the benefits of digitization.

Comments from each institution are as follows:

◆Cancer Institute Hospital of JFCR
Hospital Director Sano: "Cancer Institute Hospital of JFCR has taken a step forward. We spent more than 6 months discussing each of these institutions before we reached the point we are at today. The three institutions with a proven track record in cancer treatment kindly agreed to participate in this project while they have constructed their own databases. We are very pleased that collaboration with the three institutions has taken this research to a new phase and that we can make steady progress toward solving the issues."

Kazuhiro Suzuki (Head of Database Development Office): "Our research and development aims to build a medical information infrastructure that supports the autonomous cycle of knowledge discovery and the provision of high-quality medical care in the field of cancer. We will not just address the issues faced by medical institutions, patients, and their families but also continue our research and development in collaboration with medical institutions and the pharmaceutical industry. The objective of the research and development is to establish a business model with which cancer treatment data, pharmaceuticals, and healthcare provision form a sustainable cycle for future development and to keep the framework self-propelled even after the completion of the SIP research and development period."

◆Aichi Cancer Center
Hospital Director Yamamoto: "The electronic medical record is a record of a single patient, and how to make the most of the record is a major issue. We believe that integrating our records, medical information, and medical care details with clinical data from other leading cancer centers in Japan will contribute to patient support and medical problem resolution."

Hospital Assistant Director Seiji Ito: "I believe that the major significance of our participation in this project is twofold. One aspect is the improved accuracy and labor-saving of data access through integrating intrahospital databases. The other is the unification of data structure with other institutions, which is expected to promote collaborative research, improve the efficiency of clinical trials with companies, and increase the number of institutions participating. We hope that we can contribute to building the know-how to migrate the databases to the multicenter integrated cancer clinical database."

◆Shizuoka Cancer Center
Hospital Director Ono: "From a broader perspective, I believe that the expansion of the multicenter integrated database will contribute to the advancement of medicine because big data can be used to collect and examine cases of various rare diseases and other conditions. I also think it will be highly significant in that it will contribute to drug discovery. I am very excited about it leading to DX."

Hospital Deputy Director Hirofumi Yasui: "I have great expectations for the consolidation and utilization of real-world data through participation. We, as a hospital specializing in cancer, have a great mission of delivering new drugs. I hope that our participation will accelerate the development of clinically relevant therapies or medical treatments originating in Japan."

◆Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Director Toi: "Komagome Hospital is a cancer center with a foundation in general medicine. Our hospital has been registering cancer cases that are generally similar to the current form since 1985. In this context, we were wondering to what extent we were able to follow up on the results. For infrequent diseases, results are not readily apparent. I hope that our participation in this project will help us find new things."

Dr. Tatsu Shimoyama (Director of Oncology): "Our hospital has been operating a data center specializing in the real-world and disease registries for about 15 years. When building a database, we could not link it to external networks for security reasons such as preventing information leaks and breaches. As a result, we have been forced to expend much effort. With the introduction of this system, we believe that half of this work will be eliminated, and we will have highly suitable information for updating."