Background: Treatment outcomes of children with cancer have improved significantly in recent decades. Despite this, cancer remains the leading cause of mortality among children aged 5–9 years in Japan. The precise trends over time and the changing locations of deaths for pediatric cancer patients in Japan are not clearly elucidated. Objectives: This study aimed to validate the annual change in the number and location of deaths in children with cancer in Japan. Methods: A retrospective study was conducted using vital statistics (2005, 2010, 2015, 2020, and 2021) and detailed Japanese death records (2018). We sampled patients aged under 15 years who died of cancer, analyzing trends based on demographic characteristics, cause of death, location of death, and place of residence. Results: Over the 15-year period (2005–2020), cancer-related deaths declined, with hematological malignancies falling by approximately one-third. Concurrently, the proportion of home deaths increased significantly, rising by 30 percentage points for cancer-related deaths. This was highest for brain tumors, where more than half of the associated deaths occurred at home. Regional disparity was evident; the proportion of home deaths was higher in densely populated areas but lower in sparsely populated regions. Furthermore, only 20% of children died at designated core hospitals, while 50% died at collaborating hospitals, mostly near their residence. Conclusion: Japan has seen a decrease in pediatric cancer deaths alongside a growing trend toward home deaths. This shift indicates increased support for patient- and family-centered end-of-life care but highlights the need to strengthen collaboration in regions with fewer medical resources.
Yotani et al. (2026) studied this question.