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Integration of breast cancer care in a middle-income country: learning from Suandok Breast Cancer Network (SBCN). BMC Cancer 2022; 22:26. [PMID: 34980028 PMCID: PMC8722177 DOI: 10.1186/s12885-021-09153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. In 2002 the urgency of the situation prompted Maharaj Nakorn Chiang Mai Hospital to initiate the Suandok Breast Cancer Network (SBCN). Methods The SBCN is a not-for-profit organization in the university hospital which serves as a training and education center and provides highly specialized medical care for patients in Chiang Mai and in 5 provinces of northern Thailand, with the key mission of improving breast cancer care. The short-term goal was to overcome the barriers to engagement with breast cancer and its treatment and the long-term goal was to increase the overall survival rate of breast cancer patients in our region. Results We enrolled breast cancer patients treated at Maharaj Nakorn Chiang Mai Hospital between January 2006 and December 2015 and divided into 2 cohorts: 1485 patients who were diagnosed from 2006 to 2009 (cohort 1: early implementation of SBCN) and 2383 patients who were diagnosed from 2010 to 2015 (cohort 2: full implementation of SBCN). Criteria to measure improved cancer waiting time (CWT) would include: time to diagnosis, time to surgery, and time to radiotherapy. The 5-year overall survival (OS) of the cohort 2 was higher than that in cohort 1, at 73.8 (72.0–75.5) compared to 71.5 (69.2–73.7) (p-value = 0.03). Conclusions Reasons behind the success of project include the uniformity of care encouragement, service network development and timely access to each step of breast cancer management. The model used in SBCN could be adopted as a learning guide to improve healthcare access and outcome for breast cancer patients in low- to middle-income countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09153-0.
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Pongnikorn D, Phinyo P, Patumanond J, Daoprasert K, Phothong P, Siribumrungwong B. Individualized Prediction of Breast Cancer Survival Using Flexible Parametric Survival Modeling: Analysis of a Hospital-Based National Clinical Cancer Registry. Cancers (Basel) 2021; 13:1567. [PMID: 33805407 PMCID: PMC8037061 DOI: 10.3390/cancers13071567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/18/2022] Open
Abstract
Prognostic models for breast cancer developed from Western countries performed less accurately in the Asian population. We aimed to develop a survival prediction model for overall survival (OS) and disease-free survival (DFS) for Thai patients with breast cancer. We conducted a prognostic model research using a multicenter hospital-based cancer clinical registry from the Network of National Cancer Institutes of Thailand. All women diagnosed with breast cancer who underwent surgery between 1 January 2010 and 31 December 2011 were included in the analysis. A flexible parametric survival model was used for developing the prognostic model for OS and DFS prediction. During the study period, 2021 patients were included. Of these, 1386 patients with 590 events were available for a complete-case analysis. The newly derived individualized prediction of breast cancer survival or the IPBS model consists of twelve routinely available predictors. The C-statistics from the OS and the DFS model were 0.72 and 0.70, respectively. The model showed good calibration for the prediction of five-year OS and DFS. The IPBS model provides good performance for the prediction of OS and PFS for breast cancer patients. A further external validation study is required before clinical implementation.
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Affiliation(s)
- Donsuk Pongnikorn
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand;
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang 52000, Thailand;
| | - Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
- Musculoskeletal Science and Translational Research (MSTR) Cluster, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | | | - Pachaya Phothong
- Policy and Strategy Unit, Lampang Cancer Hospital, Lampang 52000, Thailand;
| | - Boonying Siribumrungwong
- Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand;
- Center of Excellence in Applied Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
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Suwankhong D, Liamputtong P. Early Detection of Breast Cancer and Barrier to Screening Programmes amongst Thai Migrant Women in Australia: A Qualitative Study. Asian Pac J Cancer Prev 2018; 19:1089-1097. [PMID: 29699369 PMCID: PMC6031773 DOI: 10.22034/apjcp.2018.19.4.1089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Breast cancer screening programme is seen as the best practice to detect breast cancer early. However, there are circumstances that can prevent immigrant women from attending screening programmes. Little is known about Thai migrants and the barriers to their seeking breast cancer screening when living in a new homeland. This paper aimed to discuss the barriers to attending screening services among Thai migrant women living in Australia. Methods: This study adopted qualitative approach. Semi-structured in-depth interviewing and drawing methods were employed as data collection technique with 25 Thai migrant women who had not experienced breast cancer and were living in Metropolitan Melbourne, Australia. Thematic analysis method was employed to analyse the data. Results: Basing on the Health Belief Model, most Thai migrant women did not perceive that they were at risk of breast cancer. Despite seeing a breast cancer screening programme as important, the women rarely paid attention to breast cancer screening and used the mammography services provided by the Australian health care system. The barriers included the location of the services, unfamiliar patterns of health care provision, and language difficulties. Conclusions: There are many barriers that that they encountered in Australia that prevent Thai migrant women living in Melbourne Australia to pay attention to mammographic screening service provided by Australia health system. Our findings suggest that health services and interventions need to be designed more sensitive to the needs and socio-cultural context of migrant women in general and Thai migrant women in particular.
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Affiliation(s)
- Dusanee Suwankhong
- Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung, Thailand.
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Virani S, Bilheem S, Chansaard W, Chitapanarux I, Daoprasert K, Khuanchana S, Leklob A, Pongnikorn D, Rozek LS, Siriarechakul S, Suwanrungruang K, Tassanasunthornwong S, Vatanasapt P, Sriplung H. National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens. Cancers (Basel) 2017; 9:E108. [PMID: 28817104 PMCID: PMC5575611 DOI: 10.3390/cancers9080108] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 12/20/2022] Open
Abstract
In Thailand, five cancer types-breast, cervical, colorectal, liver and lung cancer-contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC): 3.1%) and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1%) are increasing while cervical cancer (AAPC: -4.4%) is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time.
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Affiliation(s)
- Shama Virani
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand.
- Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Surichai Bilheem
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand.
| | - Wasan Chansaard
- Cancer Registry Unit, Surat Thani Cancer Hospital, Surath Thani 84100, Thailand.
| | - Imjai Chitapanarux
- Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
| | | | | | - Atit Leklob
- Cancer Unit, Lopburi Cancer Center, Lopburi 15000, Thailand.
| | - Donsuk Pongnikorn
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang 52000, Thailand.
| | - Laura S Rozek
- Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | | | - Krittika Suwanrungruang
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | | | - Patravoot Vatanasapt
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand.
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