Greeting from Chairperson
I would like to say a few words of greeting as the newly appointed Chairperson of the Japan Society of Gynecologic Oncology (JSGO). The history of the JSGO goes back to the Japan Colposcopy Association, which was founded in August 1975 by Dr. Soju Kurihara, Dr. Yoshio Tenjin, and Dr. Kiichiro Noda, who is currently Honorary Chairman. In later years, with the increasing need to integrate various groups of gynecologic oncology research being conducted by different study groups and academic societies, the Japan Society of Gynecologic Pathology and Colposcopy and the Japan Society of Ovarian Tumor Pathology merged in 1998, and became the non-profit JSGO. It became a public-interest incorporated association in 2013. The JSGO currently has 4,128, members including gynecologic oncologists, pathologists, and radiologists.
According to the National Cancer Center’s cancer registry, the total number of patients with invasive cancer of the uterine body, ovary or uterine cervix in Japan was 41,081 in 2017, accounting for approximately 10% of all newly-diagnosed cancer in women. The JSGO is engaged in creating the guidelines for the prevention, diagnosis, and treatment of gynecologic cancer and manages education and research activities in the gynecologic oncology field. It has grown into an organization that is highly needed in society to advance the gynecologic oncology and to play a role in supporting the medical welfare for the people in Japan.
Creation of the treatment guidelines
In 2004, before the releases of other guidelines related to oncology, the JSGO issued guidelines for the treatment of ovarian cancer. Subsequently, it also released the guidelines for the treatment of cervical cancer, those for the treatment of uterine body cancer, and also the world’s first guidelines for the treatment of vulvar cancer and vaginal cancer. These guidelines have significantly contributed to making equal levels of treatment for gynecologic cancers available everywhere, which helps patients and healthcare professionals share a common understanding, enhances team medical practice, and fosters the professional development of young doctors. The treatment guidelines released by the JSGO have received an excellent rating, with a total score of six out of seven, by the Japan Society of Clinical Oncology’s Cancer Guidelines Evaluation Committee. All of these guidelines have been issued in both Japanese and English. They have come to be referenced in the literature as frequently as the guidelines of the National Comprehensive Cancer Network and the European Society for Medical Oncology are. Furthermore, the JSGO’s guidelines are selected as one of the top five high-quality guidelines in the world in the clinical guidelines for cervical cancer issued by the American Society of Clinical Oncology.
Specialty certification for gynecologic oncologists
To foster and train gynecologic cancer treatment specialists, the JSGO certifies doctors who meet the specifications to become certified gynecologic oncologists. To do this, the organization has designated 241 medical facilities as training centers for gynecologic oncologists; 970 doctors have been certified so far. The Ministry of Health, Labour and Welfare allows doctors to use the qualification of “Certified gynecologic oncologist” to advertise the availability of medical specialists. A study reported that the outcomes of treatment for cervical cancer in designated training centers where certified gynecologic oncologists were available were significantly better than those found in non-designated facilities (J Gynecol Oncol 2018;29(2):e23). These results suggest that the specialty certification system contributes to improving treatment for gynecologic cancer and, consequently, to the creation of a society where recovered Japanese cancer patients can be active in their communities.
Education on gynecologic oncology for JSGO members and junior researcher mentoring
The JSGO holds educational seminars and training courses twice a year, aiming to help members acquire a wide knowledge base about gynecologic oncology, medical safety, medical ethics, and infectious disease control. Additionally, the organization organizes various kinds of promotional and educational activities to enable doctors to deliver new medical technologies to patients safely and quickly. For example, it holds hands-on seminars for the safe and appropriate employment of endoscopic surgery to gynecologic cancer, using the common curriculum across Japan. Furthermore, to foster next-generation researchers, the JSGO annually awards the Nozawa Memorial Research Grant to two junior gynecologic oncology researchers (in the fields of primary/clinical/social medicine).
Globalization and the publication of English journals
The JSGO has actively cooperated with international organizations as a member of the Union for International Cancer Control, as well as international academic societies including the International Gynecologic Cancer Society (IGCS), the International Federation of Cervical Pathology and Colposcopy (IFCPC) and the Asian Society of Gynecologic Oncology (ASGO). As part of such cooperation, the JSGO organized an international convention with the ASGO in November 2017 (chaired by Dr. Daisuke Aoki), and another with the IGCS in September 2018 (chaired by Dr. Ikuo Konishi). In addition to the existing Japanese journal, the organization also launched its official English journal, Journal of Gynecologic Oncology (pISSN: 2005-0380, eISSN: 2005-0399, impact factor: 3.30), in 2019.
Conveying information on gynecologic cancer prevention and treatment suitable for life stages of individual women to the public
The third phase of the Basic Plan to Promote Cancer Control Programs endorsed by the Cabinet in 2018 includes provision for “the enhancement of medical care for the AYA generation” (AYA generation stands for Adolescent and Young Adult). According to the Cancer Statistics in Japan 2019, the uterine cervix is the most common cancer site in women of the AYA generation, accounting for approximately 18% (excluding cancer in situ) of all cancer sites. Further, hereditary cancers, such as hereditary breast and ovarian cancer, Lynch syndrome, and Peutz-Jeghers syndrome, are also common in women. Treatment outcomes for these types of cancer are affected by the national countermeasures against the falling birthrate, as well as the measures to live with cancer (as elucidated in the third phase of the Basic Plan to Promote Cancer Control Programs mentioned above) in Japan. The JSGO widely disseminates statements and proposals regarding HPV vaccination, as well as information on new clinical strategies for gynecologic cancer such as genomic medicine and companion diagnostics, to not only JSGO members but also to the general public. For example, the JSGO recently released its views on the HPV 9-valent vaccine, the use of pembrolizumab based on MSI testing, the use of olaparib based on BRCA testing, and the treatment for hereditary breast and ovarian cancer covered by public health insurance. In 2015, to contribute to helping patients and their family members understand gynecologic cancer, the JSGO revised its “Guidelines for Treatment of Cervical, Uterine Body and Ovarian Cancer for Patients and Their Families”, the first edition of which was published in 2010, releasing the modified document as the second edition. Moreover, lectures at academic meetings of the JSGO are open to the general public.
The JSGO has established its foundation under the strong leadership of over ten successive chairpersons from its founding and has matured enough to successfully launch various projects. In the next two years, the JSGO needs to further focus on practical education for young members, delivery of information serving the public interest, and international partnerships and internships. Furthermore, it also needs to make efforts to address specific urgent issues, for example: securing finance, building and coordinating partnerships with relevant academic societies, recruiting members from the fields of pathology and radiology, determining forms of academic meetings and the Japanese journal suited to the IT society, lobbying to ensure insurance coverage for new procedures and medical technologies, and discussing a specialist certification system in the subspecialty field. The JSGO’s 11 committees will cooperate, utilizing their unique natures and abilities to solve the various challenges and problems outlined above.
We are still in the COVID-19 pandemic, with no end in sight, and so must develop the ability to respond in both the COVID-19 and post-COVID eras. One such response, for example, would be providing remote meetings, lessons, and lectures. The impact of this unprecedented global catastrophe leads us to expect the values will change in competitive societies across the world. Shinpei Goto, a doctor and a politician in Meiji to Taisho era, said, “Those who die leaving money behind are lowly, those who die leaving businesses are average, and those who die leaving human connections are the best.” It was Goto who developed and led the reconstruction strategies in the unprecedented national crisis following the Great Kanto Earthquake of 1923. Amid the COVID-19 crisis, I believe that the most crucial role of the JSGO is to strengthen further the environment in which the young clinicians and researchers who will lead the future gynecologic oncology can grow.
Finally, I would like to appreciate your further support and cooperation for the JSGO’s activities.