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Article History

Received: 6 August 2025

Accepted: 27 January 2026

First Online: 6 February 2026

Declarations

:

: Koji Kawakami has received research funds from AstraZeneca, Eisai Co., Ltd., Kyowa Kirin Co., Ltd., OMRON Corporation, and Toppan Inc.; consulting fees from Advanced Medical Care Inc., JMDC Inc., LEBER Inc., Ubicom Holdings, Inc., Santen Pharmaceutical Co., Ltd., and Shin Nippon Biomedical Laboratories Ltd.; executive compensation from Cancer Intelligence Care Systems, Inc. and Mytreya Inc.; honoraria from Kyoto University Original Co., Ltd., Pharma Business Academy, Shionogi & Co., Ltd., Taisho Pharmaceutical Co., Ltd., and SANSHO Co., Ltd; and held stock in Real World Data Co., Ltd. Satomi Yoshida has received a consulting fee from TOYOTA Konpon Research Institute, Inc. Yoko M. Nakao has been employed by the Department of Digital Health and Epidemiology, an Industry-Academia Collaboration Course supported by Eisai Co., Ltd., and Kyowa Kirin Co., Ltd.; and received a research grant from Bayer, outside of this work. Ryuya Yamamoto declares no conflicts of interest.

: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and the Helsinki Declaration of 1964 and later versions. Approval was obtained from the Ethics Committee of the Graduate School of Medicine, Kyoto University (approval number: R4051). The need for informed consent for participation was waived because the study was based on anonymized claims data. The study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.