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So WKW, Zhao W. Gender Equity in the Oncology Workforce: Barriers, Impacts, and Addressing Recommendations. Cancer Nurs 2025; 48:77. [PMID: 39485881 DOI: 10.1097/ncc.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2024]
Affiliation(s)
- Winnie K W So
- Authors' Affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, China
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Hughes T, Harper A, Gupta S, Frazier AL, van der Graaf WTA, Moreno F, Joseph A, Fidler-Benaoudia MM. The current and future global burden of cancer among adolescents and young adults: a population-based study. Lancet Oncol 2024; 25:1614-1624. [PMID: 39557059 DOI: 10.1016/s1470-2045(24)00523-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 11/20/2024]
Abstract
BACKGROUND Compared with children and older adults, the burden of cancer in adolescents and young adults (ages 15-39) is understudied. We aimed to quantify the global burden of adolescent and young adult cancer in 2022 and 2050, and explore patterns in incidence, mortality, and case fatality. METHODS In this population-based study, we used the GLOBOCAN database to quantify the number of new cases and cancer-related deaths, and corresponding age-standardised incidence and mortality rates (ASRs; per 100 000 people aged 15-39 years), in adolescents and young adults. Estimates were quantified for all cancers combined, excluding non-melanoma skin cancer, and 33 specific cancer types. Case fatality was estimated using mortality-to-incidence ratios. Overall and sex-specific estimates were calculated at the world, regional, human development index (HDI), and income level. We estimated the future cancer burden by applying the GLOBOCAN 2022 rates to sex-specific demographic projections for the year 2050 using the UN World Population Prospects 2019 revision. FINDINGS An estimated 1 300 196 cases and 377 621 cancer-related deaths occurred in adolescents and young adults in 2022. Incidence ASRs were 1·9-times higher and mortality ASRs were 1·2-times higher in females than in males (incidence ASR 52·9 vs 28·3; mortality ASR 13·1 vs 10·6). Although the incidence ASR was highest in the high-income countries, the mortality ASR was highest in the low-income countries; as a result, case fatality ranged from 12% in high-income settings to 57% in low-income settings. Of the 33 cancer types included in our analyses, breast or cervical cancer was the most frequently diagnosed cancer and cause of cancer-related death in 163 and 93 countries, respectively; incidence and mortality also varied the most by region for these cancers. Finally, the adolescent and young adult cancer burden globally is projected to increase by about 12% from 2022 to 2050, albeit with declines of 10·7% projected in very high HDI countries. The increase is expected to overwhelmingly impact low HDI settings, where the burden of both cancer cases and deaths is projected to double (a 102·3% increase). INTERPRETATION Although the adolescent and young adult cancer burden incidence is highest in the most developed settings, transitioning countries have the poorest outcomes and will face the greatest increases in burden by 2050. These findings act as a reference to the global adolescent and young adult cancer community to inform cancer control priorities and decrease global inequities. FUNDING None.
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Affiliation(s)
- Taylor Hughes
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Andrew Harper
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Arthur Child Cancer Centre, Calgary, AB, Canada
| | - Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | | | - Florencia Moreno
- Argentinian Oncopediatric Registry, National Cancer Institute, Health Ministry, Buenos Aires City, Argentina
| | - Adedayo Joseph
- NSIA-LUTH Cancer Centre, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Radiation Biology, Radiodiagnosis and Radiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Miranda M Fidler-Benaoudia
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Arthur Child Cancer Centre, Calgary, AB, Canada.
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Loh KP, Soto-Perez-de-Celis E. Addressing Ageism With Geriatric Assessment in Clinical Practice and Research. JCO Oncol Pract 2024; 20:1559-1562. [PMID: 39008787 DOI: 10.1200/op.24.00324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/13/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
Addressing ageism in clinical practice & research: #awareness #education #language and #geriassessment.
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Affiliation(s)
- Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
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Mutebi M, Tripathi V. Quantifying the wellbeing of women: what metrics matter? Lancet Glob Health 2024; 12:e1915-e1916. [PMID: 39577961 DOI: 10.1016/s2214-109x(24)00475-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 10/28/2024] [Indexed: 11/24/2024]
Affiliation(s)
- Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi 00200, Kenya.
| | - Vandana Tripathi
- MOMENTUM Safe Surgery in Family Planning and Obstetrics, EngenderHealth, Washington, DC, USA
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Moghanaki D, Eala MA, Feldman J, DiJulio TA, Gorayski P. Lung cancer-a one-way ticket. JNCI Cancer Spectr 2024; 8:pkae098. [PMID: 39504518 PMCID: PMC11540168 DOI: 10.1093/jncics/pkae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 09/26/2024] [Indexed: 11/08/2024] Open
Affiliation(s)
- Drew Moghanaki
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle Ann Eala
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States
| | | | | | - Peter Gorayski
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
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6
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Estupiñán Fdez de Mesa M, Marcu A, Ream E, Whitaker KL. Using the Candidacy Framework to understand individual, interpersonal, and system level factors driving inequities in women with breast cancer: a cross-sectional study. BJC REPORTS 2024; 2:83. [PMID: 39516542 PMCID: PMC11524000 DOI: 10.1038/s44276-024-00103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 08/26/2024] [Accepted: 09/17/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Persistent inequities in breast cancer outcomes exist. Understanding women's experiences along the care pathway is the first step to finding solutions to tackle these inequities. METHODS Secondary data analysis of the 2017/2018 English National Cancer Patient Experience Survey (n = 25,408) using logistic regression to explore inequities in care experience by sociodemographic factors (age, ethnicity, socioeconomic position, sexual orientation) across 59 survey questions. We used the Candidacy Framework to interpret and organise our findings. RESULTS Compared to older (65-74) and White British women, young (35-44, OR = 0.55 [0.44, 0.69]), Asian (OR = 0.52 [0.41, 0.67]), Black (OR = 0.67 [0.46, 0.97]) and White Other (OR = 0.63 [0.49, 0.81]) women were more likely to rate their overall care experience less positively, respectively. Similar findings were observed along all domains of the cancer pathway. Through a candidacy lens, we identified multilevel factors related to this variation including prolonged help-seeking behaviours (individual), poor patient-provider communication (interpersonal), and variation in access to healthcare professionals and resources (system level). CONCLUSION Multilevel factors influence inequities in the experience of care along the breast cancer pathway for young women and women from minoritised groups. Interventions are necessary to ensure cancer care systems are responsive to women's health needs and provide equity of care to all patients.
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Affiliation(s)
| | - Afrodita Marcu
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
| | - Emma Ream
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
| | - Katriina L Whitaker
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
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Melnyk H, Dickson VV, Bender C, Yu G, Djukic M, Merriman J. Role function in postmenopausal women during aromatase inhibitor therapy for breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01697-x. [PMID: 39425854 DOI: 10.1007/s11764-024-01697-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 10/11/2024] [Indexed: 10/21/2024]
Abstract
OBJECTIVE Few studies have examined aromatase inhibitor therapy relating to role function in breast cancer survivors of working age. Our study sought to identify how pre-therapy sociodemographic and health/treatment-related characteristics, as well as patient-reported symptoms measured every six-months, influence role function during 18 months of AI therapy for early-stage breast cancer. METHODS We performed a secondary analysis of longitudinal study data using linear mixed-effects modeling to examine role physical (RP) and role emotional (RE) functioning measured with the Medical Outcome Study Short Form 36 v2. The sample of postmenopausal women (N = 351) consisted of three cohorts: chemotherapy followed by anastrozole (CFAI), anastrozole only (AI only), and non-cancer controls. Our choice of variables and interpretation of findings was theoretically based on the Cancer Survivorship and Work Model. Stepwise backward deletion determined which predictors to include in the final model, accounting for treatment group. RESULTS Both treatment groups were associated with greater limitations in RP functioning than controls. CFAI had twice the impact on RP compared to AI only. While the RP model displayed significant predictors across sociodemographic, health/treatment, and symptom characteristics, only symptoms were associated with greater limitations in RE functioning. Findings were significant at p < .05. CONCLUSION Transitioning from acute to extended survivorship is a critical juncture in which multiple factors place breast cancer survivors at risk of diminished role function. IMPLICATIONS FOR CANCER SURVIVORS Early interventions to address role function limitations during systemic treatment may lead to better work outcomes and improve the quality of long-term survivorship.
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Affiliation(s)
- Halia Melnyk
- New York University Rory Meyers College of Nursing, New York, NY, USA.
- The Ohio State University College of Medicine, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), Columbus, OH, USA.
| | | | | | - Gary Yu
- Columbia University, New York, NY, USA
| | - Maja Djukic
- The University of Texas Health Science Center at Houston, Jane and Robert Cizik School of Nursing, Houston, TX, USA
| | - John Merriman
- New York University Rory Meyers College of Nursing, New York, NY, USA
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Avendano D, Marino MA, Bosques-Palomo BA, Dávila-Zablah Y, Zapata P, Avalos-Montes PJ, Armengol-García C, Sofia C, Garza-Montemayor M, Pinker K, Cardona-Huerta S, Tamez-Peña J. Validation of the Mirai model for predicting breast cancer risk in Mexican women. Insights Imaging 2024; 15:244. [PMID: 39387984 PMCID: PMC11466924 DOI: 10.1186/s13244-024-01808-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/01/2024] [Indexed: 10/12/2024] Open
Abstract
OBJECTIVES To validate the performance of Mirai, a mammography-based deep learning model, in predicting breast cancer risk over a 1-5-year period in Mexican women. METHODS This retrospective single-center study included mammograms in Mexican women who underwent screening mammography between January 2014 and December 2016. For women with consecutive mammograms during the study period, only the initial mammogram was included. Pathology and imaging follow-up served as the reference standard. Model performance in the entire dataset was evaluated, including the concordance index (C-Index) and area under the receiver operating characteristic curve (AUC). Mirai's performance in terms of AUC was also evaluated between mammography systems (Hologic versus IMS). Clinical utility was evaluated by determining a cutoff point for Mirai's continuous risk index based on identifying the top 10% of patients in the high-risk category. RESULTS Of 3110 patients (median age 52.6 years ± 8.9), throughout the 5-year follow-up period, 3034 patients remained cancer-free, while 76 patients developed breast cancer. Mirai achieved a C-index of 0.63 (95% CI: 0.6-0.7) for the entire dataset. Mirai achieved a higher mean C-index in the Hologic subgroup (0.63 [95% CI: 0.5-0.7]) versus the IMS subgroup (0.55 [95% CI: 0.4-0.7]). With a Mirai index score > 0.029 (10% threshold) to identify high-risk individuals, the study revealed that individuals in the high-risk group had nearly three times the risk of developing breast cancer compared to those in the low-risk group. CONCLUSIONS Mirai has a moderate performance in predicting future breast cancer among Mexican women. CRITICAL RELEVANCE STATEMENT Prospective efforts should refine and apply the Mirai model, especially to minority populations and women aged between 30 and 40 years who are currently not targeted for routine screening. KEY POINTS The applicability of AI models to non-White, minority populations remains understudied. The Mirai model is linked to future cancer events in Mexican women. Further research is needed to enhance model performance and establish usage guidelines.
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Affiliation(s)
- Daly Avendano
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México
| | - Maria Adele Marino
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario "G. Martino," University of Messina, Messina, Italy
| | | | | | - Pedro Zapata
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México
| | - Pablo J Avalos-Montes
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México
| | - Cecilio Armengol-García
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario "G. Martino," University of Messina, Messina, Italy
| | | | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Servando Cardona-Huerta
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México.
| | - José Tamez-Peña
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, México
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Rosa WE, Weiss Goitiandia S, Braybrook D, Metheny N, Roberts KE, McDarby M, Behrens M, Berkman C, Stein GL, Adedimeji A, Wakefield D, Harding R, Spence D, Bristowe K. LGBTQIA+ inclusion in the global health policy agenda: A critical discourse analysis of the Lancet Commission report archive. PLoS One 2024; 19:e0311506. [PMID: 39365801 PMCID: PMC11452035 DOI: 10.1371/journal.pone.0311506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 09/18/2024] [Indexed: 10/06/2024] Open
Abstract
CONTEXT LGBTQIA+ people worldwide experience discrimination, violence, and stigma that lead to poor health outcomes. Policy plays a crucial role in ensuring health equity and safety for LGBTQIA+ communities. Given Lancet Commissions' substantial impact on health policy across domains, we aimed to determine how LGBTQIA+ communities and their care needs are incorporated throughout Lancet Commission reports and recommendations. METHODS Using critical discourse analysis, we analyzed 102 Commissions for inclusion of and reference to LGBTQIA+ communities using 36 key terms. Three levels of analysis were conducted: 1) micro-level (overview of terminology use); 2) meso-level (visibility and placement of LGBTQIA+ references); and 3) macro-level (outlining characterizations and framing of references with consideration of broader social discourses). FINDINGS 36 of 102 (35%) Commissions referenced LGBTQIA+ communities with 801 mentions in total. There were minimal (9/36) references made in the "Executive Summary," "Recommendations," and/or "Key Messages" sections of reports. LGBTQIA+ communities were most frequently discussed in reports related to HIV/AIDS and sexual and reproductive health. Few Commissions related to public health, or chronic conditions (9/60) referenced LGBTQIA+ communities. Some reports made non-specific or unexplained references; many discussed the LGBTQIA+ population without specific reference to sub-groups. LGBTQIA+ communities were often listed alongside other marginalized groups without rationale or a description of shared needs or experiences. We identified framings (legal, vulnerability, risk) and characterizations (as victims, as blameworthy, as a problem) of LGBTQIA+ communities that contribute to problematizing discourse. CONCLUSIONS LGBTQIA+ people were rarely included in the Commissions, resulting in an inadvertent marginalization of their health needs. Policy initiatives must consider LGBTQIA+ groups from a strengths-based rather than problematizing perspective, integrating evidence-based approaches alongside community-based stakeholder engagement to mitigate inequities and promote inclusive care and policymaking.
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Affiliation(s)
- William E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Sofia Weiss Goitiandia
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, England, United Kingdom
| | - Debbie Braybrook
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, England, United Kingdom
| | - Nicholas Metheny
- School of Nursing and Health Studies University of Miami, Coral Gables, FL, United States of America
| | - Kailey E. Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, United States of America
| | - Meghan McDarby
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Mia Behrens
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Cathy Berkman
- Graduate School of Social Service, Fordham University, New York, NY, United States of America
| | - Gary L. Stein
- Wurzweiler School of Social Work, Yeshiva University, New York, NY, United States of America
| | - Adebola Adedimeji
- Department of Social Sciences and Health Policy, School of Medicine, Wake Forest University, Winston-Salem, NC, United States of America
| | - Donna Wakefield
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Wolfson Palliative Care Research Centre, University of Hull, Hull, United Kingdom
| | - Richard Harding
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, England, United Kingdom
| | | | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, England, United Kingdom
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Liebermann E, Patwardhan V, Usmanova G, Aktar N, Agrawal S, Bhamare P, McCarthy M, Ginsburg O, Kumar S. Barriers to Follow-Up of an Abnormal Clinical Breast Examination in Uttar Pradesh, India: A Qualitative Study. JCO Glob Oncol 2024; 10:e2400001. [PMID: 39388655 PMCID: PMC11487994 DOI: 10.1200/go.24.00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 07/17/2024] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
PURPOSE To understand key barriers to diagnostic follow-up for women with an abnormal clinical breast examination (CBE) at the primary care level in the Uttar Pradesh state in India. We also explored acceptability of mobile phones to address barriers to CBE follow-up for women. MATERIALS AND METHODS We conducted 28 semistructured in-depth interviews with 12 women with an abnormal CBE at the primary health facility who did not have diagnostic follow-up, four community health workers, nine health care providers from health facilities in rural and urban settings, and three state-level decision makers. Interviews were audiorecorded, transcribed verbatim, and translated from Hindi to English. Thematic analysis was conducted using Dedoose qualitative software. Themes were organized by multilevel barriers to follow-up. RESULTS Key barriers to CBE follow-up included knowledge, fear, and stigma about breast cancer; women's health not being prioritized in the family; discomfort seeing male providers; and difficulty navigating the diagnostic facility. Despite community education and outreach efforts by community health workers (known as Accredited Social Health Activists), lack of awareness of breast cancer and the importance of follow-up for abnormal CBE remains a barrier to early detection. Despite widespread access to mobile phones, perceived acceptability varied among stakeholders regarding mobile phone use for breast health education and communication with clients. CONCLUSION Knowledge, cultural, and health system barriers challenge women's ability to follow recommendations for diagnostic follow-up of an abnormal CBE. Multilevel and gender-responsive strategies are needed to address these barriers. Our results suggest that mobile phones could be used to further improve breast health awareness, patient navigation, and tracking, and further research is needed.
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Affiliation(s)
| | - Vaibhav Patwardhan
- Monitoring, Evaluation and Research, Jhpiego India Country Office, New Delhi, India
| | - Gulnoza Usmanova
- Monitoring, Evaluation and Research, Jhpiego India Country Office, New Delhi, India
| | - Nadeem Aktar
- Jhpiego India, Jhpiego India Country Office, New Delhi, India
| | - Shivani Agrawal
- Jhpiego India, Jhpiego India Country Office, New Delhi, India
| | - Parag Bhamare
- Jhpiego India, Jhpiego India Country Office, New Delhi, India
| | - Maura McCarthy
- Jhpiego, a Johns Hopkins University Affiliate, Baltimore, MD
| | - Ophira Ginsburg
- Center for Global Health, National Cancer Institute, Bethesda, MD
| | - Somesh Kumar
- Jhpiego, a Johns Hopkins University Affiliate, Baltimore, MD
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Estupiñán Fdez de Mesa M, Marcu A, Ream E, Whitaker KL. Socioeconomic inequities in care experienced by women with breast cancer in England: An intersectional cross-sectional study. Eur J Oncol Nurs 2024; 72:102648. [PMID: 39106587 DOI: 10.1016/j.ejon.2024.102648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/28/2024] [Accepted: 06/22/2024] [Indexed: 08/09/2024]
Abstract
PURPOSE Guided by the Intersectionality Framework, we examined the differential in breast cancer care experience across population subgroups in England. METHODS Secondary data analysis using the 2017/2018 National Cancer Patient Experience Surveys. We used disaggregated descriptive statistics (mean, standard errors, 95% confidence interval) to analyse 26,030 responses from female breast cancer patients to a question relating to overall care experience categorised by age, ethnicity, and sexual orientation in their intersection with social position. We then used logistic regression to investigate the odds (Odds Ratio (OR), 95% confidence intervals) of reporting positive care experience adjusting for patient, clinical, and Trust level factors. RESULTS Poorer care experience was predominantly reported by the most deprived younger and minoritised ethnic groups. Statistically significant findings were observed in adjusted multivariable analyses. Compared to patients aged 65-74 years, younger respondents were less likely to rate their care favourably (16-34 years old ORadj. = 0.55 (0.36-0.84). Compared to White British, Asian (ORadj. = 0.51 (0.39-0.66)) and Black African women (ORadj. = 0.53 (0.33-0.88)) were less likely to rate their care favourably. The least affluent respondents were less likely to rate their care favourably (ORadj. = 0.79 (0.64-0.97)). CONCLUSION There is evidence of inequity in overall cancer care experience among female breast cancer patients in England, particularly among women living at the specific intersection of age, ethnicity, and socioeconomic position. Future research is necessary to understand the mechanisms underlying breast cancer inequities. Policymakers, commissioners, and providers should consider the existence of multiple forms of marginalisation to inform improvement initiatives targeting patients at higher risk of vulnerability.
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Affiliation(s)
| | - Afrodita Marcu
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
| | - Emma Ream
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
| | - Katriina L Whitaker
- School of Health Sciences, University of Surrey, Research Park, Guildford, Surrey, GU2 7YH, UK
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Simba H, Kapambwe S, Bates MJ, Anorlu R, Mutebi M, Guida F, Schüz J, McCormack V. Impact of Cancer Across the Intergenerational Family: A Multidimensional Perspective From African Countries. JCO Glob Oncol 2024; 10:e2400116. [PMID: 39361909 DOI: 10.1200/go.24.00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/07/2024] [Accepted: 08/25/2024] [Indexed: 10/05/2024] Open
Affiliation(s)
- Hannah Simba
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Sharon Kapambwe
- World Health Organisation African Region Office (WHO AFRO), Brazzaville, Congo
| | - Maya J Bates
- Department of Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Florence Guida
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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13
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Murthy SS, Trapani D, Cao B, Bray F, Murthy S, Kingham TP, Are C, Ilbawi AM. Premature mortality trends in 183 countries by cancer type, sex, WHO region, and World Bank income level in 2000-19: a retrospective, cross-sectional, population-based study. Lancet Oncol 2024; 25:969-978. [PMID: 38964357 PMCID: PMC11329430 DOI: 10.1016/s1470-2045(24)00274-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature mortality from non-communicable diseases, including cancer, by 2030. However, there is a paucity of data on premature mortality rates by cancer type. In this study, we examine annual rates of change for cancer-specific premature mortality and classify whether countries are on track to reach SDG 3.4 targets. METHODS This is a retrospective, cross-sectional, population-based study investigating premature mortality trends from 2000-19 using the WHO Global Health Estimates data. All cancers combined and thirteen individual cancers in 183 countries were examined by WHO region, World Bank income level, and sex. The risk of premature mortality was calculated for ages 30-69 years, independent of other competing causes of death, using standard life table methods. The primary objective was to compute average annual rate of change in premature mortality from 2000 to 2019. Secondary objectives assessed whether this annual rate of change would be sufficient to reach SDG 3.4. targets for premature mortality by 2030. FINDINGS This study was conducted using data retrieved for the years 2000-19. Premature mortality rates decreased in 138 (75%) of 183 countries across all World Bank income levels and WHO regions, however only eight (4%) countries are likely to meet the SDG 3.4 targets for all cancers combined. Cancers where early detection strategies exist, such as breast and colorectal cancer, have higher declining premature mortality rates in high-income countries (breast cancer 48 [89%] of 54 and colorectal cancer 45 [83%]) than in low-income countries (seven [24%] of 29 and four [14%]). Cancers with primary prevention programmes, such as cervical cancer, have more countries with declining premature mortality rates (high-income countries 50 [93%] of 54 and low-income countries 26 [90%] of 29). Sex-related disparities in premature mortality rates vary across WHO regions, World Bank income groups, and by cancer type. INTERPRETATION There is a greater reduction in premature mortality for all cancers combined and for individual cancer types in high-income countries compared with lower-middle-income and low-income countries. However, most countries will not reach the SDG 3.4 target. Cancers with early detection strategies in place, such as breast and colorectal cancers, are performing poorly in premature mortality compared with cancers with primary prevention measures, such as cervical cancer. Investments toward prevention, early detection, and treatment can potentially accelerate declines in premature mortality. FUNDING WHO.
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Affiliation(s)
- Shilpa S Murthy
- Department of Surgery, Division of Colon and Rectal Surgery, Yale University School of Medicine, New Haven, CT, USA.
| | - Dario Trapani
- Department of Haematology and Oncology, University of Milan, Milan, Italy; European Institute of Oncology, IRCCS, Milan, Italy
| | - Bochen Cao
- Department of Data and Analytics, WHO, Geneva, Switzerland
| | - Freddie Bray
- Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Shashanka Murthy
- Infectious Disease Institute and Centre of Microbiome Science, Ohio State University, Columbus, OH, USA
| | - Thomas Peter Kingham
- Department of Surgery, Division of Surgical Oncology, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Chandrakanth Are
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Centre, Omaha, NE, USA
| | - André M Ilbawi
- Department of Non-Communicable Diseases, WHO, Geneva, Switzerland
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14
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Patel M. Primary Prevention in Cervical Cancer-Current Status and Way Forward. J Obstet Gynaecol India 2024; 74:287-291. [PMID: 39280196 PMCID: PMC11399356 DOI: 10.1007/s13224-024-02048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 09/18/2024] Open
Abstract
The effect of cancer in women has varied effects. Overall malignancies of the breast, cervix, and ovary account for over 43% of all cancer cases in India. Globally, cervical cancer is fourth cancer in terms of incidence among women, following breast, lung, and colorectal cancer. However, this illness primarily affects women in India, where it is the second most frequent malignancy after breast cancer. HPV-related cervical cancer is a serious public health issue that has a solution. In 2020, the World Health Organization (WHO) launched a global initiative to eliminate cervical cancer which set targets for three important strategies: HPV vaccination, cervical cancer screening, and treatment. The WHO's "Best Buys" recommendations for cancer sub-set place vaccination of females between the ages of 9 and 14 at the top of the list. In India, efforts are underway to increase the number of teenage girls receiving the human papillomavirus (HPV) vaccine. The nation granted licenses for bivalent and quadrivalent HPV vaccinations in 2008, and in 2018, a nonavalent vaccine was approved. It is important to keep in mind that the cervical carcinoma vaccination is not a quick fix; thus, screening for the disease should continue. Any nation can potentially significantly lower the incidence of cervical cancer by carefully combining economical, high-coverage vaccinations with well-organized screening programs. Since 9-14 years is the ideal age range before sexual debut in today's world, this is the key vaccine age range. Estimates of vaccine effectiveness for younger adolescents, those between the ages of 9 and 14 years, varied from roughly 74 to 93%. Let us envision an India of the future where girls grow up with one fewer cancer threatening their life and a place where cervical cancer has been eradicated.
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Affiliation(s)
- Madhuri Patel
- Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra India
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15
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Dee EC, Pramesh CS, Booth CM, Rubagumya F, Mutebi M, Feliciano EJG, Eala MAB, Cerri GG, Ginsburg O, Gyawali B, Moraes FY. Growing the global cancer care system: success stories from around the world and lessons for the future. J Natl Cancer Inst 2024; 116:1193-1197. [PMID: 38663853 PMCID: PMC11308163 DOI: 10.1093/jnci/djae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 08/09/2024] Open
Abstract
Despite major biomedical advancements in various realms of oncology, the benefits of these developments are not equitably distributed, particularly in underresourced settings. Although much work has described the challenges and systemic barriers in global cancer control, in this article we focus on success stories. This article describes clinical care delivered at Rwanda's Butaro Cancer Center of Excellence, the cancer research collaborations under India's National Cancer Grid, and the efforts of Latin America's Institute of Cancer of São Paulo in advancing cancer care and training. These examples highlight the potential of strategic collaborations and resource allocation strategies in improving cancer care globally. We emphasize the critical role of partnerships between physicians and allied health professionals, funders, and policy makers in enhancing access to treatment and infrastructure, advancing contextualized research and national guidelines, and establishing regional and global collaborations. We also draw attention to challenges faced in diverse global settings and outline benchmarks to measure success in the fight against cancer.
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Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C S Pramesh
- National Cancer Grid and Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, MH, India
| | - Christopher M Booth
- Department of Oncology, Queen’s University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
| | - Fidel Rubagumya
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Erin Jay G Feliciano
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Medicine, NYC Health + Hospitals/Elmhurst, Icahn School of Medicine at Mt. Sinai, Queens, NY, USA
| | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila, Philippines
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Giovanni G Cerri
- Department of Radiology and Oncology, University of São Paulo Medical School, São Paulo, Brazil
| | - Ophira Ginsburg
- Center for Global Health, US National Cancer Institute, Rockville, MD, USA
| | - Bishal Gyawali
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
- Departments of Oncology and Public Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Fabio Ynoe Moraes
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
- Department of Oncology, Kingston General Hospital, Queen’s University, Kingston, ON, Canada
- Latin America Cooperative Oncology Group, Porto Alegre, Brazil
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16
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Whitaker KL, Perchyk T, Kerrison RS, Lemanska A. Challenges in understanding inequities in help-seeking for possible cancer symptoms. BMC GLOBAL AND PUBLIC HEALTH 2024; 2:49. [PMID: 39681941 DOI: 10.1186/s44263-024-00082-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/05/2024] [Indexed: 12/18/2024]
Abstract
Tackling inequities in cancer outcomes is a global health priority. One avenue for improving early diagnosis of cancer is to ensure people know when and how to seek help for cancer symptoms and that this knowledge (and behaviour) is equitably distributed across the population. In this perspective piece we highlight the challenges in understanding sociodemographic differences in help-seeking behaviour (for example, how help-seeking is defined / conceptualised and subsequently assessed), as well as challenges with using existing datasets that are now more readily accessible than ever. Addressing these will strengthen methodological approaches to understand inequities in help-seeking and ways to tackle them.
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Affiliation(s)
- Katriina L Whitaker
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
| | - Tetyana Perchyk
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Robert S Kerrison
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Agnieszka Lemanska
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Data Science Department, National Physical Laboratory, Teddington, UK
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17
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Hirst JE, Witt A, Mullins E, Womersley K, Muchiri D, Norton R. Delivering the promise of improved health for women and girls in England. Lancet 2024; 404:11-14. [PMID: 38945139 DOI: 10.1016/s0140-6736(24)01347-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 07/02/2024]
Affiliation(s)
- Jane Elizabeth Hirst
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK.
| | - Alice Witt
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK
| | - Edward Mullins
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK
| | - Kate Womersley
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK; NHS Lothian, Edinburgh, Scotland
| | - Dorcus Muchiri
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK
| | - Robyn Norton
- The George Institute for Global Health, Imperial College London, London W12 7RZ, UK
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18
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Columbres RC, Feliciano EJG, Catedral LI, Zaldarriaga JMH, Eala MAB, Flores JA, Tangco ED, Florez N, Ting FIL, Dee EC. Financial Sequelae of Cancer for Patients' Family Members and Caregivers: A Focus on the Philippines. JCO Glob Oncol 2024; 10:e2400074. [PMID: 38991186 DOI: 10.1200/go.24.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 07/13/2024] Open
Affiliation(s)
- Rod Carlo Columbres
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
- College of Osteopathic Medicine, William Carey University, Hattiesburg, MS
| | - Erin Jay G Feliciano
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Medicine, NYC Health + Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, Queens, NY
| | | | - Jose Ma H Zaldarriaga
- Department of Radiation Oncology, St Luke's Medical Center, Metro Manila, Philippines
| | - Michelle Ann B Eala
- University of the Philippines College of Medicine, Manila, Philippines
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | | | - Enrico D Tangco
- Department of Radiation Oncology, The Medical City, Pasig City, Philippines
| | - Narjust Florez
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Frederic Ivan L Ting
- Division of Medical Oncology, Department of Internal Medicine, Corazon Locsin Montelibano Memorial Regional Hospital, Bacolod, Philippines
- Department of Clinical Sciences, College of Medicine, University of St La Salle, Bacolod, Philippines
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19
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Gehrels AM, Wagner AD, Besselink MG, Verhoeven RHA, van Eijck CHJ, van Laarhoven HWM, Wilmink JW, van der Geest LG. Gender differences in tumor characteristics, treatment allocation and survival in stage I-III pancreatic cancer: a nationwide study. Eur J Cancer 2024; 206:114117. [PMID: 38781719 DOI: 10.1016/j.ejca.2024.114117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/25/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Sex and gender are modulators of health and disease and may have impact on treatment allocation and survival in patients with cancer. In this study, we analyzed the impact of sex and gender on treatment allocation and overall survival in patients with stage I-III pancreatic cancer. METHODS Patients with stage I-III pancreatic cancer diagnosed between 2015 and 2020 were selected from the nationwide Netherlands Cancer Registry. Associations between sex and gender and the probability of receiving surgical and/or systemic treatment were examined with multivariable logistic regression analyses. Overall survival was assessed with log rank test and multivariable Cox proportional hazard analysis. RESULTS Among 6855 patients, 51.2 % were female. Multivariable logistic regression analyses with adjustment for known confounders (age, performance status, comorbidities, tumor location, tumor stage and previous malignancies) showed that females less often received systemic chemotherapy compared to males (OR 0.799, 95 %CI 0.703-0.909, p < .001). No difference was found in the probability for undergoing surgical resection. Furthermore, females had worse overall survival compared to males (median OS 8.5 and 9.2 months respectively, 95 %CI 8.669-9.731). CONCLUSION This nationwide study found that female patients with stage I-III pancreatic cancer significantly less often received systemic treatment and had worse overall survival as compared to males. Disparities in pancreatic cancer care can be decreased by recognizing and resolving potential obstacles or biases in treatment decision-making.
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Affiliation(s)
- A M Gehrels
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| | - A D Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M G Besselink
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands
| | - R H A Verhoeven
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | - C H J van Eijck
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - H W M van Laarhoven
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - J W Wilmink
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - L G van der Geest
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands.
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20
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Praça MSL, de Sousa FTR, Cândido EB, Lamaita RM, Wender MCO, Silva AL. Beyond the diagnosis: gender disparities in the social and emotional impact of cancer. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S115. [PMID: 38865535 PMCID: PMC11164259 DOI: 10.1590/1806-9282.2024s115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Mariana Seabra Leite Praça
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | | | - Eduardo Batista Cândido
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Rívia Mara Lamaita
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
| | - Maria Celeste Osório Wender
- Universidade Federal do Rio Grande do Sul, Department of Gynecology and Obstetrics – Porto Alegre (RS), Brazil
| | - Agnaldo Lopes Silva
- Universidade Federal de Minas Gerais, Department of Obstetrics and Gynecology – Belo Horizonte (MG), Brazil
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21
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Johnson SE, Samson M. Cancer stigma: the need for policy and programmatic action. J Natl Cancer Inst Monogr 2024; 2024:45-50. [PMID: 38836525 DOI: 10.1093/jncimonographs/lgae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Accepted: 03/20/2024] [Indexed: 06/06/2024] Open
Abstract
Cancer is a stigmatized disease in many countries that impacts the quality of life and mental health of people affected by cancer. This commentary examines some dimensions of cancer stigma and has been developed based on insights from participants in a Union for International Cancer Control program dedicated to cancer patient organizations in low- and middle-income countries. Aimed at program managers and policy makers, this commentary highlights the importance of developing strategies to reduce cancer stigma in cancer control programs in different contexts, working closely with community-based civil society organizations and those with lived experience of cancer to understand, evaluate, and take action regarding the impact of cancer stigma on health-seeking behavior and patients' quality of life.
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Affiliation(s)
| | - Mélanie Samson
- Capacity Building, Union for International Cancer Control, Geneva, Switzerland
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22
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Popescu C, Raiby JA, Bellizzi S. Cancer among women and girls in Syrian refugee populations. Lancet 2024; 403:1631-1632. [PMID: 38677853 DOI: 10.1016/s0140-6736(24)00592-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/21/2024] [Indexed: 04/29/2024]
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Martinez A, Delpierre C, Grosclaude P, Lamy S. Integrating gender into cancer research. Lancet 2024; 403:1631. [PMID: 38677852 DOI: 10.1016/s0140-6736(24)00593-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/21/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Amalia Martinez
- Equity research team, CERPOP-UMR1295, Équipe Labellisée Ligue contre le cancer, Inserm, University Toulouse III Paul Sabatier, Toulouse 31000, France; Registre des cancers du Tarn, Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France.
| | - Cyrille Delpierre
- Equity research team, CERPOP-UMR1295, Équipe Labellisée Ligue contre le cancer, Inserm, University Toulouse III Paul Sabatier, Toulouse 31000, France
| | - Pascale Grosclaude
- Equity research team, CERPOP-UMR1295, Équipe Labellisée Ligue contre le cancer, Inserm, University Toulouse III Paul Sabatier, Toulouse 31000, France; Registre des cancers du Tarn, Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
| | - Sébastien Lamy
- Equity research team, CERPOP-UMR1295, Équipe Labellisée Ligue contre le cancer, Inserm, University Toulouse III Paul Sabatier, Toulouse 31000, France; Registre des cancers du Tarn, Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
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25
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Orozco-Núñez E, Ojeda-Arroyo E, Cerecer-Ortiz N, Guerrero-López CM, Ramírez-Pérez BM, Heredia-Pi I, Allen-Leigh B, Feeny E, Serván-Mori E. Gender and non-communicable diseases in Mexico: a political mapping and stakeholder analysis. Health Res Policy Syst 2024; 22:46. [PMID: 38605301 PMCID: PMC11007965 DOI: 10.1186/s12961-024-01125-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/17/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Mexico and other low- and middle-income countries (LMICs) present a growing burden of non-communicable diseases (NCDs), with gender-differentiated risk factors and access to prevention, diagnosis and care. However, the political agenda in LMICs as it relates to health and gender is primarily focused on sexual and reproductive health rights and preventing violence against women. This research article analyses public policies related to gender and NCDs, identifying political challenges in the current response to women's health needs, and opportunities to promote interventions that recognize the role of gender in NCDs and NCD care in Mexico. METHODS We carried out a political mapping and stakeholder analysis during July-October of 2022, based on structured desk research and interviews with eighteen key stakeholders related to healthcare, gender and NCDs in Mexico. We used the PolicyMaker V5 software to identify obstacles and opportunities to promote interventions that recognize the role of gender in NCDs and NCD care, from the perspective of the political stakeholders interviewed. RESULTS We found as a political obstacle that policies and stakeholders addressing NCDs do not take a gender perspective, while policies and stakeholders addressing gender equality do not adequately consider NCDs. The gendered social and economic aspects of the NCD burden are not widely understood, and the multi-sectoral approach needed to address these aspects is lacking. Economic obstacles show that budget cuts exacerbated by the pandemic are a significant obstacle to social protection mechanisms to support those caring for people living with NCDs. CONCLUSIONS Moving towards an effective, equity-promoting health and social protection system requires the government to adopt an intersectoral, gender-based approach to the prevention and control of NCDs and the burden of NCD care. Despite significant resource constraints, policy innovation may be possible given the willingness among some stakeholders to collaborate, particularly in the labour and legal sectors. However, care will be needed to ensure the implementation of new policies has a positive impact on both gender equity and health outcomes. Research on successful approaches in other contexts can help to identify relevant learnings for Mexico.
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Affiliation(s)
- Emanuel Orozco-Núñez
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Enai Ojeda-Arroyo
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Nadia Cerecer-Ortiz
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Carlos M Guerrero-López
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | | | - Ileana Heredia-Pi
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Betania Allen-Leigh
- Center for Population Health Research, The National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Emma Feeny
- The George Institute for Global Health, Sidney, Australia
| | - Edson Serván-Mori
- Center for Health Systems Research, The National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico.
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26
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Martinez A, Grosclaude P, Lamy S, Delpierre C. The Influence of Sex and/or Gender on the Occurrence of Colorectal Cancer in the General Population in Developed Countries: A Scoping Review. Int J Public Health 2024; 69:1606736. [PMID: 38660497 PMCID: PMC11039791 DOI: 10.3389/ijph.2024.1606736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Objective: Gender as the "sociocultural role of sex" is underrepresented in colorectal cancer incidence studies, potentially resulting in underestimated risk factors' consequences and inequalities men/women. We aim to explore how literature focusing on differences between men and women in the incidence of colorectal cancer interprets these differences: through sex- or gender-related mechanisms, or both? Methods: We conducted a scoping review using PubMed and Google Scholar. We categorized studies based on their definitions of sex and/or gender variables. Results: We reviewed 99 studies, with 7 articles included in the analysis. All observed differences between men and women. Six articles examined colorectal cancer incidence by gender, but only 2 used the term "gender" to define exposure. One article defined its "sex" exposure variable as gender-related mechanisms, and two articles used "sex" and "gender" interchangeably to explain these inequalities. Gender mechanisms frequently manifest through health behaviors. Conclusion: Our results underscore the need for an explicit conceptual framework to disentangle sex and/or gender mechanisms in colorectal cancer incidence. Such understanding would contribute to the reduction and prevention of social health inequalities.
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Affiliation(s)
- Amalia Martinez
- Equity Research Team, Centre d’Epidémiologie et de Recherche en santé des POPulations, UMR 1295 (Équipe Labellisée Ligue Contre le Cancer), Inserm, University Toulouse III Paul Sabatier, Toulouse, France
- Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
- Registre des Cancers du Tarn, Toulouse, France
| | - Pascale Grosclaude
- Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
- Registre des Cancers du Tarn, Toulouse, France
| | - Sébastien Lamy
- Equity Research Team, Centre d’Epidémiologie et de Recherche en santé des POPulations, UMR 1295 (Équipe Labellisée Ligue Contre le Cancer), Inserm, University Toulouse III Paul Sabatier, Toulouse, France
- Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
- Registre des Cancers du Tarn, Toulouse, France
- Equipe Labellisée Ligue Contre le Cancer, Toulouse, France
| | - Cyrille Delpierre
- Equity Research Team, Centre d’Epidémiologie et de Recherche en santé des POPulations, UMR 1295 (Équipe Labellisée Ligue Contre le Cancer), Inserm, University Toulouse III Paul Sabatier, Toulouse, France
- Institut Universitaire du Cancer de Toulouse-Oncopole (Institut Claudius Regaud), Toulouse, France
- Equipe Labellisée Ligue Contre le Cancer, Toulouse, France
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27
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Kyrgiou M, Bowden S, Denny L, Fagotti A, Abu-Rustum NR, Ramirez PT, Querleu D. Innovation in gynaecological cancer: highlighting global disparities. Lancet Oncol 2024; 25:425-430. [PMID: 38461833 DOI: 10.1016/s1470-2045(24)00137-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Maria Kyrgiou
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction - Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK.
| | - Sarah Bowden
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction - Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK
| | - Lynette Denny
- Faculty of Health Sciences, University of Cape Town, Observatory, South Africa
| | - Anna Fagotti
- Department of Woman and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Pedro T Ramirez
- Department of Obstetrics & Gynecology, Houston Methodist, Houston, TX, USA)
| | - Denis Querleu
- Department of Woman and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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28
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Anandasabapathy S, Asirwa C, Grover S, Mungo C. Cancer burden in low-income and middle-income countries. Nat Rev Cancer 2024; 24:167-170. [PMID: 38332323 DOI: 10.1038/s41568-023-00659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 02/10/2024]
Affiliation(s)
| | | | - Surbhi Grover
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Chemtai Mungo
- Department of Obstetrics and Gynecology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
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29
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Zhan Y, Mao P, Gao F, Shi Q. Content and Duration of Doctor-Patient Communication in Outpatient Oncology Follow-Up Consultations in China. Cureus 2024; 16:e55597. [PMID: 38590457 PMCID: PMC11000034 DOI: 10.7759/cureus.55597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose This study aimed to analyze the content of counseling between cancer patients and physicians during outpatient follow-up, assess the duration of different communication content, and explore the influencing factors. Patients and methods We observed consecutive cancer patients without a first diagnosis of malignancy who presented to the oncology outpatient clinic of a public hospital from October through December 2023. A structured observation form was used to record the content and duration of doctor-patient communication. All variables were electronically recorded and stored on a data management platform. Multiple linear regression was used to examine the determinants of consultation duration. Results Our study included 620 cancer patients, of whom 281 individuals had distant metastasis. The average consultation duration for 620 cancer patients was 4.85 minutes (standard deviation of 3.09 minutes). The category of doctor-patient communication was routine outpatient follow-up, involving 182 patients, with an average consultation duration of 3.81 minutes (standard deviation of 2.24 minutes). The main communication content for 51 patients was about the admission procedures, with an average consultation duration of 3.00 minutes (standard deviation of 1.92 minutes). For 67 patients, the primary communication involved the prescription of anti-tumor medications, with an average consultation duration of 3.70 minutes (standard deviation of 2.30 minutes). Symptom control discussions were the main communication content with 107 patients, with an average consultation duration of 5.91 minutes (standard deviation of 3.44 minutes). The main communication content of 24 patients involved medical insurance reimbursement, with an average duration of 7.75 minutes (standard deviation of 4.63 minutes). Consultations accompanied by caregivers and the presence of metastatic tumors were positively associated with consultation duration, whereas female patients with genital malignancies were negatively associated with consultation duration. Communication about symptom management and communication about medical insurance reimbursement was positively associated with the duration of medical consultations. Communication about administering the formalities requisite for patient admission was negatively associated with the consultation duration. Conclusion We classified the main contents of doctor-patient communication in the oncology outpatient clinic and found that the contents of doctor-patient communication tended to be monotone and systematized. Oncology outpatient models should consider the integration of caregiver involvement. The reason for the shorter outpatient consultation duration in female patients of cancer primary in the reproductive system needs further investigation. The intricate medical insurance reimbursement process poses an increasing time challenge for outpatient clinicians. In addition, the adequacy and effectiveness of symptom management services provided to cancer patients during oncology outpatient follow-up require further evaluation and review.
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Affiliation(s)
- Yinxia Zhan
- School of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Peiyang Mao
- School of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Feng Gao
- Department of Oncology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, CHN
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, Chongqing, CHN
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30
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Barbier JM, Schwarz J. Beyond sex and gender: Call for an intersectional feminist approach in biomedical research. Eur J Intern Med 2024; 121:44-45. [PMID: 38185599 DOI: 10.1016/j.ejim.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Jeanne M Barbier
- Health and Gender Unit, Department of Ambulatory Care, University Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, Lausanne CH-1011, Switzerland; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Joëlle Schwarz
- Health and Gender Unit, Department of Ambulatory Care, University Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, Lausanne CH-1011, Switzerland.
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31
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Cavalli F, Mikkelsen B, Weiderpass E, Sullivan R, Jaffray D, Gospodarowicz M. World Oncology Forum amplifies its appeal in global fight against cancer. Lancet Oncol 2024; 25:170-174. [PMID: 38301688 DOI: 10.1016/s1470-2045(24)00010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Franco Cavalli
- European School of Oncology, Bellinzona, Switzerland; Institute for Oncology Research, 6500 Bellinzona, Switzerland.
| | - Bente Mikkelsen
- UHC/Communicable and Noncommunicable Diseases, World Health Organization Headquarters, Geneva, Switzerland
| | | | | | - David Jaffray
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mary Gospodarowicz
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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Affiliation(s)
- Márcia Mendonça Carneiro
- Women & Health
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- ORIGEN Center for Reproductive Medicine, Belo Horizonte, Brazil
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Carcel C, Haupt S, Arnott C, Yap ML, Henry A, Hirst JE, Woodward M, Norton R. A life-course approach to tackling noncommunicable diseases in women. Nat Med 2024; 30:51-60. [PMID: 38242981 DOI: 10.1038/s41591-023-02738-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/27/2023] [Indexed: 01/21/2024]
Abstract
Women's health has been critically underserved by a failure to look beyond women's sexual and reproductive systems to adequately consider their broader health needs. In almost every country in the world, noncommunicable diseases are the leading causes of death for women. Among these, cardiovascular disease (including heart disease and stroke) and cancer are the major causes of mortality. Risks for these conditions exist at each stage of women's lives, but recognition of the unique needs of women for the prevention and management of noncommunicable diseases is relatively recent and still emerging. Once they are diagnosed, treatments for these diseases are often costly and noncurative. Therefore, we call for a strategic, innovative life-course approach to identifying disease triggers and instigating cost-effective measures to minimize exposure in a timely manner. Prohibitive barriers to implementing this holistic approach to women's health exist in both the social arena and the medical arena. Recognizing these impediments and implementing practical approaches to surmounting them is a rational approach to advancing health equity for women, with ultimate benefits for society as a whole.
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Affiliation(s)
- Cheryl Carcel
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
| | - Sue Haupt
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Clare Arnott
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mei Ling Yap
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Liverpool and Macarthur Cancer Therapy Centres, South-West Sydney Local Health District, Sydney, New South Wales, Australia
- Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), South-Western Sydney Clinical School, Ingham Institute, UNSW, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Amanda Henry
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW, Sydney, New South Wales, Australia
- Department of Women's and Children's Health, St George Hospital, Sydney, New South Wales, Australia
| | - Jane E Hirst
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Mark Woodward
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Robyn Norton
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
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Heidari S, Torreele E, Gülmezoglu AM, Sekalala S, Burke-Shyne N, Chappuis GL. A gender-responsive Pandemic Accord is needed for a healthier, equitable future. Lancet 2023; 402:2176-2179. [PMID: 37802094 DOI: 10.1016/s0140-6736(23)02038-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Shirin Heidari
- GENDRO, Geneva, Switzerland; Gender Centre, Geneva Graduate Institute, Maison de la Paix, Geneva, Switzerland
| | - Els Torreele
- Independent Research and consultant, Geneva, Switzerland; Institute for Innovation and Public Purpose, University College London, London WC1B 5BP, UK.
| | | | | | - Naomi Burke-Shyne
- Harm Reduction International, London, UK; Global Health Centre, Geneva Graduate Institute, Geneva, Switzerland
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35
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Bertagnolli MM. Women, power, and cancer: a need for change and a force for progress. Lancet 2023; 402:2053-2055. [PMID: 37774724 DOI: 10.1016/s0140-6736(23)01847-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Monica M Bertagnolli
- National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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36
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Hammad N, Ginsburg O. Investing in gender equality and equitable access improves outcomes. Lancet Oncol 2023; 24:1302-1304. [PMID: 37924820 DOI: 10.1016/s1470-2045(23)00521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023]
Affiliation(s)
- Nazik Hammad
- St. Michael's Hospital Department of Medicine, University of Toronto, Toronto, ON M5B 1W8, Canada.
| | - Ophira Ginsburg
- Centre for Global Health, US National Cancer Institute, Rockville, MD, USA
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37
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Frick C, Rumgay H, Vignat J, Ginsburg O, Nolte E, Bray F, Soerjomataram I. Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: a population-based study. Lancet Glob Health 2023; 11:e1700-e1712. [PMID: 37774721 PMCID: PMC10581909 DOI: 10.1016/s2214-109x(23)00406-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Cancer is a leading cause of premature mortality globally. This study estimates premature deaths at ages 30-69 years and distinguishes these as deaths that are preventable (avertable through primary or secondary prevention) or treatable (avertable through curative treatment) in 185 countries worldwide. METHODS For this population-based study, estimated cancer deaths by country, cancer, sex, and age groups were retrieved from the International Agency for Research on Cancer's GLOBOCAN 2020 database. Crude and age-adjusted cancer-specific years of life lost (YLLs) were calculated for 36 cancer types. FINDINGS Of the estimated all-ages cancer burden of 265·6 million YLLs, 182·8 million (68·8%) YLLs were due to premature deaths from cancer globally in 2020, with 124·3 million (68·0%) preventable and 58·5 million (32·0%) treatable. Countries with low, medium, or high human development index (HDI) levels all had greater proportions of YLLs at premature ages than very high HDI countries (68·9%, 77·0%, and 72·2% vs 57·7%, respectively). Lung cancer was the leading contributor to preventable premature YLLs in medium to very high HDI countries (17·4% of all cancers, or 29·7 million of 171·3 million YLLs), whereas cervical cancer led in low HDI countries (26·3% of all preventable cancers, or 1·83 million of 6·93 million YLLs). Colorectal and breast cancers were major treatable cancers across all four tiers of HDI (25·5% of all treatable cancers in combination, or 14·9 million of 58·5 million YLLs). INTERPRETATION Alongside tailored programmes of early diagnosis and screening linked to timely and comprehensive treatment, greater investments in risk factor reduction and vaccination are needed to address premature cancer inequalities. FUNDING Erasmus Mundus Exchange Programme and the International Agency for Research on Cancer. TRANSLATIONS For the German, French, Spanish and Chinese translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Clara Frick
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Harriet Rumgay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jérôme Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ophira Ginsburg
- Centre for Global Health, National Cancer Institute, Bethesda, MD, USA
| | - Ellen Nolte
- London School of Hygiene & Tropical Medicine, London, UK
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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38
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Seven days in medicine: 27 Sep to 3 Oct 2023. BMJ 2023; 383:2265. [PMID: 37797977 DOI: 10.1136/bmj.p2265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
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39
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Wise J. Health experts call for a "feminist approach" to cancer care. BMJ 2023; 382:2247. [PMID: 37770076 DOI: 10.1136/bmj.p2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
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