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Gitonga I, Desmond D, Maguire R. Who uses connected health technologies after a cancer diagnosis? evidence from the US Health Information National Trends Survey. J Cancer Surviv 2024:10.1007/s11764-024-01615-1. [PMID: 38744797 DOI: 10.1007/s11764-024-01615-1] [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: 10/19/2023] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE As the number of people living with and beyond cancer increases, connected health technologies offer promise to enhance access to care and support, while reducing costs. However, uptake of connected health technologies may vary depending on sociodemographic and health-related variables. This study aimed to investigate demographic and health predictors of connected health technology use among people living with and beyond cancer. METHODS Cross-sectional data from the US Health Information National Trends Survey Version 5 Cycle 4 (H5c4) was used. Regression analysis was used to examine associations between sociodemographic factors and the use of connected health technologies. The sample was restricted to individuals who self-reported a cancer diagnosis or history of cancer. RESULTS In this cycle, 626 respondents self-reported a cancer diagnosis, with 41.1% using connected health technologies (health and wellness apps and/or wearable devices). Most were female (58.9%) and white (82.5%); 43.4% had graduated college or higher education. One third (33.6%) had a household income of $75,000 or more. Respondents who were younger, have higher education, were living as married, had higher incomes, had higher self-rated health and had higher health-related self-efficacy were significantly more likely to use connected health technologies. There were no significant associations between gender, race, stratum, time since diagnosis, history of anxiety or depression, and use of connected health technologies among people living with and beyond cancer. CONCLUSIONS Connected health technology use among people living with and beyond cancer is associated with sociodemographic factors. Future research should examine these demographic disparities as the use of connected health technologies in healthcare continues to gather momentum. IMPLICATIONS FOR CANCER SURVIVORS The study underscores a disparity in connected heath technology usage among people living with and beyond cancer. There is a pressing need for research into adoption barriers and interventions to ensure equitable digital healthcare integration among this population, especially with the heightened adoption of technology post COVID-19 pandemic.
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Affiliation(s)
- Isaiah Gitonga
- Department of Psychology, Maynooth University, Maynooth, Ireland.
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland.
| | - Deirdre Desmond
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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2
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Briercheck E, Pyle D, Adams C, Atun R, Booth C, Dent J, Garcia-Gonzalez P, Ilbawi A, Jazieh AR, Kerr D, Knaul F, Kobayashi E, Lim C, Maza M, Milner D, Navarro MF, O'Brien M, Rodriguez-Galindo C, Sullivan R, Torode J, Vokes E, Gralow J. Unification of Efforts to Improve Global Access to Cancer Therapeutics: Report From the 2022/2023 Access to Essential Cancer Medicines Stakeholder Summit. JCO Glob Oncol 2024; 10:e2300256. [PMID: 38781548 DOI: 10.1200/go.23.00256] [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: 07/25/2023] [Revised: 12/06/2023] [Accepted: 03/24/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE There is an urgent need to improve access to cancer therapy globally. Several independent initiatives have been undertaken to improve access to cancer medicines, and additional new initiatives are in development. Improved sharing of experiences and increased collaboration are needed to achieve substantial improvements in global access to essential oncology medicines. METHODS The inaugural Access to Essential Cancer Medicines Stakeholder Meeting was organized by ASCO and convened at the June 2022 ASCO Annual Meeting in Chicago, IL, with two subsequent meetings, Union for International Cancer Control World Cancer Congress held in Geneva, Switzerland, in October 2022 and at the ASCO Annual Meeting in June of 2023. Invited stakeholders included representatives from cancer institutes, physicians, researchers, professional societies, the pharmaceutical industry, patient advocacy organizations, funders, cancer organizations and foundations, policy makers, and regulatory bodies. The session was moderated by ASCO. Past efforts and current and upcoming initiatives were initially discussed (2022), updates on progress were provided (2023), and broad agreement on resulting action steps was achieved with participants. RESULTS Summit participants recognized that while much work was ongoing to enhance access to cancer therapeutics globally, communication and synergy across projects and organizations could be enhanced by providing a platform for collaboration and shared expertise. CONCLUSION The summit resulted in new cross-stakeholder insights and planned collaboration addressing barriers to accessing cancer medications. Specific actions and timelines for implementation and reporting were established.
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Affiliation(s)
- Edward Briercheck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Doug Pyle
- American Society of Clinical Oncology, Alexandria, VA
| | - Cary Adams
- Union for International Cancer Control, Geneva, Switzerland
| | - Rifat Atun
- Department of Global Health and Population, Harvard University, Boston, MA
| | - Christopher Booth
- Division of Cancer Care and Epidemiology, Queen's University, Kingston, Canada
| | | | | | - Andre Ilbawi
- Cancer Programme, World Health Organization, Geneva, Switzerland
| | | | - David Kerr
- Nuffield Department of Clinical Laboratory Sciences, Oxford University, Oxford, United Kingdom
| | - Felicia Knaul
- Department of Public Health Sciences, University of Miami, Miami, FL
| | | | | | | | - Danny Milner
- Union for International Cancer Control, Geneva, Switzerland
| | | | | | | | - Richard Sullivan
- Institute of Cancer Policy, King's College London, London, United Kingdom
| | - Julie Torode
- Institute of Cancer Policy, King's College London, London, United Kingdom
| | - Everett Vokes
- Department of Medicine, University of Chicago, Chicago, IL
| | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, VA
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Prasad S, Johnston E, Birkland B, Prasad R, Carlson A, von Pressentin K. Primary health care has not been prioritised enough. Lancet 2024; 403:1449. [PMID: 38614484 DOI: 10.1016/s0140-6736(24)00500-2] [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: 09/17/2023] [Accepted: 03/07/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Shailendra Prasad
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Esther Johnston
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; The Wright Center National Family Medicine Residency at Healthpoint, Auburn, WA, USA
| | - Bassim Birkland
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Ramakrishna Prasad
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; National Centre for Primary Care Research & Policy, Academy of Family Physicians of India, Bengaluru, India
| | - Annika Carlson
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA
| | - Klaus von Pressentin
- Global Education Network for Primary Health Care (GEN-PHC), Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; Department of Family, Community and Emergency Care, University of Cape Town, Cape Town, South Africa
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4
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Gwanika Y, Rice HE, Metcalf M, Espinoza P, Kajoka HD, Rice HE, Staton C, Mmbaga BT, Majaliwa E, Smith ER, Cotache-Condor C. Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study. BMC Cancer 2024; 24:457. [PMID: 38609910 PMCID: PMC11010397 DOI: 10.1186/s12885-024-12168-y] [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: 12/08/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
INTRODUCTION The SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pandemic on access to cancer care for children and adolescents in Northern Tanzania. METHODS In this cross-sectional study, we assessed the demographic and clinical characteristics of 547 pediatric and adolescent cancer patients (ages 0-19 years old) between 2016 and 2022 using the population-based Kilimanjaro Cancer Registry (KCR). We categorized data into pre-COVID-19 (2016-2019) and COVID-19 (2020-2022) eras, and performed descriptive analyses of diagnostic, treatment, and demographic information. A secondary analysis was conducted on a subset of 167 patients with stage of diagnosis at presentation. RESULTS Overall admissions nearly doubled during the pandemic (n = 190 versus 357). The variety of diagnoses attended at KCMC increased during the pandemic, with only five groups of diseases reported in 2016 to twelve groups of diseases in 2021. Most patients were diagnosed at a late stage (stage III or IV) across eras, with the proportion of under-five years old patients increasing late-diagnoses from 29.4% (before the pandemic), 52.8% (during the pandemic), when compared to the overall cohort. Around 95% of children in this age category reported late-stage diagnosis during the pandemic. Six out of the twelve cancer site groups also reported an increase in late-stage diagnosis. During the pandemic, the proportion of children receiving surgery increased from 15.8 to 30.8% (p < 0.001). CONCLUSION Childhood and adolescent cancer care changed in Northern Tanzania during the COVID-19 pandemic, with increased late-stage diagnoses presentations among younger patients and the increased use of surgical therapies in the context of a growing practice. Understanding the impact of the COVID-19 pandemic on pediatric and adolescent cancer care can help us better adapt healthcare systems and interventions to the emerging needs of children and adolescents with cancer in the midst of a health crisis.
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Affiliation(s)
- Yotham Gwanika
- Pediatric Hematology and Oncology Services, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Hannah E Rice
- Duke Primary Care, Population Health, Duke University, Durham, NC, USA
| | | | - Pamela Espinoza
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Happiness D Kajoka
- Pediatric Hematology and Oncology Services, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Henry E Rice
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Center for Global Surgery and Health Equity, Duke University, Durham, NC, USA
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Blandina T Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Esther Majaliwa
- Pediatric Hematology and Oncology Services, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
- Kilimanjaro Christian Medical University College, Moshi, Tanzania.
| | - Emily R Smith
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Cesia Cotache-Condor
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Center for Global Surgery and Health Equity, Duke University, Durham, NC, USA
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Beckett M, Al Balushi M, Chan J, Iakovenko V, Roumeliotis M, Hanna T, Huang F, Barkati M, Rodin D, Bourque JM. Pan-Canadian Survey of Radiation Oncology Professional Involvement in Global Oncology Initiatives in Low- and Middle-Income Countries. JCO Glob Oncol 2024; 10:e2300174. [PMID: 38574301 DOI: 10.1200/go.23.00174] [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: 05/26/2023] [Revised: 12/18/2023] [Accepted: 01/30/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Canadian radiation oncology professionals have a strong history of involvement in global oncology initiatives worldwide. This pan-Canadian survey-based study was conducted to determine the current level of engagement of Canadian radiation oncologists (ROs) and medical physicists (MPs) in global oncology initiatives and broaden the development of these activities. MATERIALS AND METHODS This was a cross-sectional study. The survey was designed to characterize current levels of engagement of Canadian ROs and MPs in global oncology initiatives. The survey was open from March 2019 to April 2020. It was disseminated to all Canadian Association of Radiation Oncology and Canadian Organization of Medical Physicists members with two subsequent email reminders. RESULTS Survey responses were received from 40 (93%) of the 43 Canadian cancer treatment centers that offer radiotherapy. At least one RO responded at 34 centers (79%) and one MP from 34 centers (79%) with some overlap. A response was received from a total of 93 participants, 47 ROs and 46 MPs. Of all survey participants, 58% reported some experience with global oncology. Nineteen percent of the participants surveyed were currently directly involved in short- or long-term projects, more than half of which have opportunity for additional staff involvement. The projects spanned 26 countries in South America, Africa, and Asia. Quality improvement and capacity building accounted for 27% and 20% of initiatives, respectively. The most common area of engagement was in direct treatment care, accounting for 56% of the projects. CONCLUSION This study demonstrates the landscape of involvement of Canadian ROs and MPs in global oncology initiatives. The study also highlights areas of opportunity for broadening international participation and collaboration as it relates to global oncology for Canadian radiation oncology professionals.
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Affiliation(s)
- Matthew Beckett
- Division of Radiation Oncology, The Ottawa Hospital, Ottawa, ON, Canada
- University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | | | - Jessica Chan
- Division of Radiation Oncology, University of British Columbia, Vancouver, BC, Canada
| | | | - Michael Roumeliotis
- Department of Physics and Astronomy, University of Calgary, Calgary, AB, Canada
| | - Tim Hanna
- Cancer Research Institute, Queens University, Kingston, ON, Canada
| | - Fleur Huang
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Maroie Barkati
- Departement de Radio-oncologie, Université de Montréal, Montreal, QC, Canada
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Jean-Marc Bourque
- Departement de Radio-oncologie, Université de Montréal, Montreal, QC, Canada
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Henderson R. Invisible cancers: Seeing, knowing, enacting and proving cancers in Haiti. Soc Sci Med 2024; 347:116733. [PMID: 38493681 DOI: 10.1016/j.socscimed.2024.116733] [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: 09/12/2023] [Revised: 02/08/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
In Haiti, pathological confirmation of a cancer diagnosis is often delayed or impossible, imaging is expensive and imperfect, and many tests are unavailable. Physicians frequently struggle to establish cancers at a level of certainty required by "evidence based" standards, delaying definitive diagnosis and rendering some cancers permanently "suspected." I use 22 months of participant observation at the two largest cancer treatment programs in Haiti, as well as throughout Haiti's fragmented healthcare system, to look closely at processes of diagnosis and management of suspected 'cancers' which may never fully come to be. I argue that as global oncology becomes increasingly standardized, local practices are forced into alignment with a global knowledge basis that governs the knowability/unknowability of cancer. Using three case studies drawn from this work, I examine relationships among visibility, power, expertise and the replication of inequity through the governance of knowledge production. Finally, I examine the implications of these processes for cancer care in the global south.
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7
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Briercheck EL, Wrigglesworth JM, Garcia-Gonzalez I, Scheepers C, Ong MC, Venkatesh V, Stevenson P, Annamalay AA, Coffey DG, Anderson AB, Garcia-Gonzalez P, Wagner MJ. Treatment Access for Gastrointestinal Stromal Tumor in Predominantly Low- and Middle-Income Countries. JAMA Netw Open 2024; 7:e244898. [PMID: 38568688 PMCID: PMC10993077 DOI: 10.1001/jamanetworkopen.2024.4898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/01/2024] [Indexed: 04/05/2024] Open
Abstract
Importance Gastrointestinal stromal tumor (GIST) is a rare cancer treated with the tyrosine kinase inhibitors imatinib mesylate or sunitinib malate. In general, in low- and middle-income countries (LMICs), access to these treatments is limited. Objective To describe the demographic characteristics, treatment duration, and survival of patients with GIST in LMICs treated with imatinib and sunitinib through The Max Foundation programs. Design, Setting, and Participants This retrospective database cohort analysis included patients in 2 access programs administered by The Max Foundation: the Glivec International Patient Assistance Program (GIPAP), from January 1, 2001, to December 31, 2016, and the Max Access Solutions (MAS) program, January 1, 2017, to October 12, 2020. Sixty-six countries in which The Max Foundation facilitates access to imatinib and sunitinib were included. Participants consisted of patients with approved indications for imatinib, including adjuvant therapy in high-risk GIST by pathologic evaluation of resected tumor or biopsy-proven unresectable or metastatic GIST. All patients were reported to have tumors positive for CD117(c-kit) by treating physicians. A total of 9866 patients received treatment for metastatic and/or unresectable disease; 2100 received adjuvant imatinib; 49 received imatinib from another source and were only included in the sunitinib analysis; and 53 received both imatinib and sunitinib through The Max Foundation programs. Data were analyzed from October 13, 2020, to January 30, 2024. Main Outcomes and Measures Demographic and clinical information was reported by treating physicians. Kaplan-Meier analysis was used to estimate time to treatment discontinuation (TTD) and overall survival (OS). An imputation-based informed censoring model estimated events for patients lost to follow-up after treatment with adjuvant imatinib. Patients who were lost to follow-up with metastatic or unresectable disease were presumed deceased. Results A total of 12 015 unique patients were included in the analysis (6890 male [57.6%]; median age, 54 [range, 0-100] years). Of these, 2100 patients were treated with imatinib in the adjuvant setting (median age, 54 [range 8-88] years) and 9866 were treated with imatinib for metastatic or unresectable disease (median age, 55 [range, 0-100] years). Male patients comprised 5867 of 9866 patients (59.5%) with metastatic or unresectable disease and 1023 of 2100 patients (48.7%) receiving adjuvant therapy. The median OS with imatinib for unresectable or metastatic disease was 5.8 (95% CI, 5.6-6.1) years, and the median TTD was 4.2 (95% CI, 4.1-4.4) years. The median OS with sunitinib for patients with metastatic or unresectable GIST was 2.0 (95% CI, 1.5-2.5) years; the median TTD was 1.5 (95% CI, 1.0-2.1) years. The 10-year OS rate in the adjuvant setting was 73.8% (95% CI, 67.2%-81.1%). Conclusions and Relevance In this cohort study of patients with GIST who were predominantly from LMICs and received orally administered therapy through the GIPAP or MAS programs, outcomes were similar to those observed in high-resource countries. These findings underscore the feasibility and relevance of administering oral anticancer therapy to a molecularly defined population in LMICs, addressing a critical gap in cancer care.
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Affiliation(s)
- Edward Lloyd Briercheck
- Division of Hematology, University of Washington, Seattle
- now with Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | | | - Philip Stevenson
- Division of Clinical Biostatistics, Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | - Aparna B. Anderson
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts
| | | | - Michael J. Wagner
- now with Dana-Farber Cancer Institute, Boston, Massachusetts
- Division of Oncology, University of Washington, Seattle
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
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Nzitakera A, Surwumwe JB, Ndoricyimpaye EL, Uwamungu S, Uwamariya D, Manirakiza F, Ndayisaba MC, Ntakirutimana G, Seminega B, Dusabejambo V, Rutaganda E, Kamali P, Ngabonziza F, Ishikawa R, Rugwizangoga B, Iwashita Y, Yamada H, Yoshimura K, Sugimura H, Shinmura K. The spectrum of TP53 mutations in Rwandan patients with gastric cancer. Genes Environ 2024; 46:8. [PMID: 38459566 PMCID: PMC10921722 DOI: 10.1186/s41021-024-00302-y] [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: 11/23/2023] [Accepted: 02/18/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Gastric cancer is the sixth most frequently diagnosed cancer and third in causing cancer-related death globally. The most frequently mutated gene in human cancers is TP53, which plays a pivotal role in cancer initiation and progression. In Africa, particularly in Rwanda, data on TP53 mutations are lacking. Therefore, this study intended to obtain TP53 mutation status in Rwandan patients with gastric cancer. RESULTS Formalin-fixed paraffin-embedded tissue blocks of 95 Rwandan patients with histopathologically proven gastric carcinoma were obtained from the University Teaching Hospital of Kigali. After DNA extraction, all coding regions of the TP53 gene and the exon-intron boundary region of TP53 were sequenced using the Sanger sequencing. Mutated TP53 were observed in 24 (25.3%) of the 95 cases, and a total of 29 mutations were identified. These TP53 mutations were distributed between exon 4 and 8 and most of them were missense mutations (19/29; 65.5%). Immunohistochemical analysis for TP53 revealed that most of the TP53 missense mutations were associated with TP53 protein accumulation. Among the 29 mutations, one was novel (c.459_477delCGGCACCCGCGTCCGCGCC). This 19-bp deletion mutation in exon 5 caused the production of truncated TP53 protein (p.G154Wfs*10). Regarding the spectrum of TP53 mutations, G:C > A:T at CpG sites was the most prevalent (10/29; 34.5%) and G:C > T:A was the second most prevalent (7/29; 24.1%). Interestingly, when the mutation spectrum of TP53 was compared to three previous TP53 mutational studies on non-Rwandan patients with gastric cancer, G:C > T:A mutations were significantly more frequent in this study than in our previous study (p = 0.013), the TCGA database (p = 0.017), and a previous study on patients from Hong Kong (p = 0.006). Even after correcting for false discovery, statistical significance was observed. CONCLUSIONS Our results suggested that TP53 G:C > T:A transversion mutation in Rwandan patients with gastric cancer is more frequent than in non-Rwandan patients with gastric cancer, indicating at an alternative etiological and carcinogenic progression of gastric cancer in Rwanda.
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Affiliation(s)
- Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Jean Bosco Surwumwe
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Ella Larissa Ndoricyimpaye
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Université Catholique de Louvain, Médecine Expérimentale, Brussels, 1348, Belgium
| | - Schifra Uwamungu
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-40530, Sweden
| | - Delphine Uwamariya
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Marie Claire Ndayisaba
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Gervais Ntakirutimana
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Benoit Seminega
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Vincent Dusabejambo
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Eric Rutaganda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Placide Kamali
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - François Ngabonziza
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Rei Ishikawa
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Belson Rugwizangoga
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kimio Yoshimura
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
- Sasaki Institute Sasaki Foundation, 2-2 Kanda Surugadai, Chiyoda-Ku, Tokyo, 101-0062, Japan.
| | - Kazuya Shinmura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
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Van Loon K, Breithaupt L, Ng D, DeBoer RJ, Buckle GC, Bialous S, Hiatt RA, Volberding P, Hermiston ML, Ashworth A. A roadmap to establishing global oncology as a priority initiative within a National Cancer Institute-designated cancer center. J Natl Cancer Inst 2024; 116:345-351. [PMID: 38060289 PMCID: PMC10919326 DOI: 10.1093/jnci/djad255] [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: 08/02/2023] [Revised: 11/06/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
As the burden of cancers impacting low- and middle-income countries is projected to increase, formation of strategic partnerships between institutions in high-income countries and low- and middle-income country institutions may serve to accelerate cancer research, clinical care, and training. As the US National Cancer Institute and its Center for Global Health continue to encourage cancer centers to join its global mission, academic cancer centers in the United States have increased their global activities. In 2015, the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, responded to the call for international partnership in addressing the global cancer burden through the establishment of the Global Cancer Program as a priority initiative. In developing the Global Cancer Program, we galvanized institutional support to foster sustained, bidirectional, equitable, international partnerships in global cancer control. Our focus and intent in disseminating this commentary is to share experiences and lessons learned from the perspective of a US-based, National Cancer Institute-designated cancer center and to provide a roadmap for other high-income institutions seeking to strategically broaden their missions and address the complex challenges of global cancer control. Herein, we review the formative evaluation, governance, strategic planning, investments in career development, funding sources, program evaluation, and lessons learned. Reflecting on the evolution of our program during the first 5 years, we observed in our partners a powerful shift toward a locally driven priority setting, reduced dependency, and an increased commitment to research as a path to improve cancer outcomes in resource-constrained settings.
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Affiliation(s)
- Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Lindsay Breithaupt
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Dianna Ng
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Pathology, UCSF, San Francisco, CA, USA
| | - Rebecca J DeBoer
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Geoffrey C Buckle
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Stella Bialous
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- School of Nursing, UCSF, San Francisco, CA, USA
| | - Robert A Hiatt
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA
| | - Paul Volberding
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA
| | - Michelle L Hermiston
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Alan Ashworth
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
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10
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Wadhwa A, Roscoe C, Duran EA, Kwan L, Haroldsen CL, Shelton JB, Cullen J, Knudsen BS, Rettig MB, Pyarajan S, Nickols NG, Maxwell KN, Yamoah K, Rose BS, Rebbeck TR, Iyer HS, Garraway IP. Neighborhood Deprivation, Race and Ethnicity, and Prostate Cancer Outcomes Across California Health Care Systems. JAMA Netw Open 2024; 7:e242852. [PMID: 38502125 PMCID: PMC10951732 DOI: 10.1001/jamanetworkopen.2024.2852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/25/2024] [Indexed: 03/20/2024] Open
Abstract
Importance Non-Hispanic Black (hereafter, Black) individuals experience worse prostate cancer outcomes due to socioeconomic and racial inequities of access to care. Few studies have empirically evaluated these disparities across different health care systems. Objective To describe the racial and ethnic and neighborhood socioeconomic status (nSES) disparities among residents of the same communities who receive prostate cancer care in the US Department of Veterans Affairs (VA) health care system vs other settings. Design, Setting, and Participants This cohort study obtained data from the VA Central Cancer Registry for veterans with prostate cancer who received care within the VA Greater Los Angeles Healthcare System (VA cohort) and from the California Cancer Registry (CCR) for nonveterans who received care outside the VA setting (CCR cohort). The cohorts consisted of all males with incident prostate cancer who were living within the same US Census tracts. These individuals received care between 2000 and 2018 and were followed up until death from any cause or censoring on December 31, 2018. Data analyses were conducted between September 2022 and December 2023. Exposures Health care setting, self-identified race and ethnicity (SIRE), and nSES. Main Outcomes and Measures The primary outcome was all-cause mortality (ACM). Cox proportional hazards regression models were used to estimate hazard ratios for associations of SIRE and nSES with prostate cancer outcomes in the VA and CCR cohorts. Results Included in the analysis were 49 461 males with prostate cancer. Of these, 1881 males were in the VA cohort (mean [SD] age, 65.3 [7.7] years; 833 Black individuals [44.3%], 694 non-Hispanic White [hereafter, White] individuals [36.9%], and 354 individuals [18.8%] of other or unknown race). A total of 47 580 individuals were in the CCR cohort (mean [SD] age, 67.0 [9.6] years; 8183 Black individuals [17.2%], 26 206 White individuals [55.1%], and 13 191 individuals [27.8%] of other or unknown race). In the VA cohort, there were no racial disparities observed for metastasis, ACM, or prostate cancer-specific mortality (PCSM). However, in the CCR cohort, the racial disparities were observed for metastasis (adjusted odds ratio [AOR], 1.36; 95% CI, 1.22-1.52), ACM (adjusted hazard ratio [AHR], 1.13; 95% CI, 1.04-1.24), and PCSM (AHR, 1.15; 95% CI, 1.05-1.25). Heterogeneity was observed for the racial disparity in ACM in the VA vs CCR cohorts (AHR, 0.90 [95% CI, 0.76-1.06] vs 1.13 [95% CI, 1.04-1.24]; P = .01). No evidence of nSES disparities was observed for any prostate cancer outcomes in the VA cohort. However, in the CCR cohort, heterogeneity was observed for nSES disparities with ACM (AHR, 0.82; 95% CI, 0.80-0.84; P = .002) and PCSM (AHR, 0.86; 95% CI, 0.82-0.89; P = .007). Conclusions and Relevance Results of this study suggest that racial and nSES disparities were wider among patients seeking care outside of the VA health care system. Health systems-related interventions that address access barriers may mitigate racial and socioeconomic disparities in prostate cancer.
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Affiliation(s)
- Ananta Wadhwa
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
| | - Charlotte Roscoe
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Elizabeth A. Duran
- VA San Diego Healthcare System, San Diego, California
- Department of Radiation Oncology, University of California, San Diego, San Diego
- Center for Health Equity Education and Research, University of California, San Diego, La Jolla
| | - Lorna Kwan
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Urology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles
| | - Candace L. Haroldsen
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City
- IDEAS Center (COIN), VA Salt Lake City Healthcare System, Salt Lake City, Utah
| | - Jeremy B. Shelton
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Case Western Reserve, Cleveland, Ohio
| | - Beatrice S. Knudsen
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City
- IDEAS Center (COIN), VA Salt Lake City Healthcare System, Salt Lake City, Utah
| | - Mathew B. Rettig
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Urology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles
- Department of Medicine, Division of Hematology-Oncology, David Geffen School of Medicine at UCLA, Los Angeles
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles
| | | | - Nicholas G. Nickols
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Urology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles
| | - Kara N. Maxwell
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Kosj Yamoah
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- James A. Haley Veterans Hospital, Tampa, Florida
| | - Brent S. Rose
- VA San Diego Healthcare System, San Diego, California
- Department of Radiation Oncology, University of California, San Diego, San Diego
- Center for Health Equity Education and Research, University of California, San Diego, La Jolla
| | - Timothy R. Rebbeck
- VA Boston Healthcare System, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hari S. Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Isla P. Garraway
- Department of Surgical and Perioperative Care, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Urology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles
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11
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Ghose A, Stanway S, Sirohi B, Mutebi M, Adomah S. Advanced Breast Cancer Care: The Current Situation and Global Disparities. Semin Oncol Nurs 2024; 40:151551. [PMID: 38065813 DOI: 10.1016/j.soncn.2023.151551] [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: 09/22/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Advanced breast cancer (ABC) is an incurable disease. The number of people living with ABC has increased globally. Disparities in ABC care exist at both individual and system levels. ABC cases in most low- and middle-income countries (LMICs) are underreported due to a lack of national cancer registries. Harmonized guidelines for resource stratification and capacity building in LMICs are under way. DATA SOURCES MEDLINE, Cochrane, and Google Scholar databases were used. CONCLUSION To improve ABC outcomes and resolve disparities, more robust health systems or pathways need to be developed across the cancer continuum in addition to social education. IMPLICATIONS FOR NURSING PRACTICE So far, the ABC specialist nurse role has been variable globally, and to conquer such variability, an international online nurse education and training program is in practice.
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Affiliation(s)
- Aruni Ghose
- United Kingdom and Ireland Global Cancer Network; Barts Cancer Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK; Medical Oncology, Medway NHS Foundation Trust, Kent, UK; Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Immuno-Oncology Clinical Network, UK; European Cancer Organisation.
| | - Susannah Stanway
- United Kingdom and Ireland Global Cancer Network; and Breast Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Bhawna Sirohi
- United Kingdom and Ireland Global Cancer Network; and Medical Oncology, BALCO Medical Centre, Vedanta Medical Research Foundation, Chattisgarh, India
| | - Miriam Mutebi
- Breast Surgical Oncology, Aga Khan University, Nairobi, Kenya
| | - Sarah Adomah
- Breast Unit, Royal Marsden NHS Foundation Trust, London, UK
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12
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Chiong E, Saad M, Hamid ARA, Ong-Cornel AB, Lojanapiwat B, Pripatnanont C, Serrano D, Songco J, Sin LC, Hakim L, Chua MLK, Nguyen NP, Phuong PC, Patnaik RS, Umbas R, Kanesvaran R. Prostate cancer management in Southeast Asian countries: a survey of clinical practice patterns. Ther Adv Med Oncol 2024; 16:17588359231216582. [PMID: 38249332 PMCID: PMC10798109 DOI: 10.1177/17588359231216582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/19/2023] [Indexed: 01/23/2024] Open
Abstract
Background Prostate cancer (PC) has a serious public health impact, and its incidence is rising due to the aging population. There is limited evidence and consensus to guide the management of PC in Southeast Asia (SEA). We present real-world data on clinical practice patterns in SEA for advanced PC care. Method A paper-based survey was used to identify clinical practice patterns and obtain consensus among the panelists. The survey included the demographics of the panelists, the use of clinical guidelines, and clinical practice patterns in the management of advanced PC in SEA. Results Most panelists (81%) voted prostate-specific antigen (PSA) as the most effective test for early PC diagnosis and risk stratification. Nearly 44% of panelists agreed that prostate-specific membrane antigen positron emission tomography-computed tomography imaging for PC diagnostic and staging information aids local and systemic therapy decisions. The majority of the panel preferred abiraterone acetate (67%) or docetaxel (44%) as first-line therapy for symptomatic mCRPC patients. Abiraterone acetate (50%) is preferred over docetaxel as a first-line treatment in metastatic castration-sensitive prostate cancer patients with high-volume disease. However, the panel did not support the use of abiraterone acetate in non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Apalutamide (75%) is the preferred treatment option for patients with nmCRPC. The cost and availability of modern treatments and technologies are important factors influencing therapeutic decisions. All panelists supported the use of generic versions of approved therapies. Conclusion The survey results reflect real-world management of advanced PC in a SEA country. These findings could be used to guide local clinical practices and highlight the financial challenges of modern healthcare.
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Affiliation(s)
- Edmund Chiong
- Department of Urology, National University Hospital, Department of Surgery, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
| | - Marniza Saad
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Agus Rizal A.H. Hamid
- Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Indonesia
| | | | - Bannakij Lojanapiwat
- Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
| | | | - Dennis Serrano
- Division of Urology, Department of Surgery, University of the Philippines College of Medicine – Philippines General Hospital, Manila, Philippines
| | - Jaime Songco
- Department of Urology, Cancer Center, Makati Medical Center, Manila, Philippines
| | - Loh Chit Sin
- Department of Urology, Department of Surgery, Gleneagles Hospital, Kuala Lumpur, Malaysia
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Airlangga University/Airlangga University Teaching Hospital, Surabaya, East Java, Indonesia
| | - Melvin Lee Kiang Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore, Singapore
| | | | - Pham Cam Phuong
- The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam
| | - Ravi Sekhar Patnaik
- Department of Oncology, The Brunei Cancer Centre (TBCC), Pantai Jerudong Specialist Centre, Jerudong, Brunei
| | - Rainy Umbas
- Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Indonesia
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13
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Cong S, Bai S, Zhang M, Bi Y, Wang Y, Jin S, He H. A study on metabolic characteristics and metabolic markers of gastrointestinal tumors. Cancer Biol Ther 2023; 24:2255369. [PMID: 37705174 PMCID: PMC10503448 DOI: 10.1080/15384047.2023.2255369] [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: 05/22/2022] [Revised: 09/28/2022] [Accepted: 06/06/2023] [Indexed: 09/15/2023] Open
Abstract
Tumor cells have significant heterogeneity in metabolism and are closely related to prognosis, gene mutation, and subtype. However, this association has not been demonstrated in reports of gastrointestinal tumors. In this study, we constructed four metabolic subtypes and identified four gene signatures using the expression data and clinical information of 252 metabolism-related genes from TCGA and NCBI databases for gastric adenocarcinoma (STAD) and colorectal cancer (COAD and READ). MC1 had the worst prognosis compared to other classifications. GSig1 was mainly related to drug metabolism and was the highest in MC1 with the worst prognosis, while the other subtypes were mainly related to glucose metabolism pathways. This difference also existed in other different malignant tumors. In addition, metabolic typing was associated with chemotherapeutic drug response and tumor heterogeneity, which indicated that monitoring metabolic typing could contribute to drug efficacy and gene-targeted therapy. In conclusion, we identified differences among subtypes in clinical characteristics such as prognosis and revealed the potential function of metabolic subtype in response to chemotherapeutic agents and oncogene mutations. This work highlighted the potential clinical meaning of metabolic subtype and characteristics in drug therapy and prognosis assessment of malignant tumors.
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Affiliation(s)
- Shan Cong
- Department of Laparoscopic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - shanshan Bai
- Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Minghao Zhang
- Department of Vascular Interventional, Affiliated Hongqi Hospital of Mudanjiang Medical College, Mudanjiang, China
| | - yanfang Bi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - yu Wang
- Department of Laparoscopic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - shi Jin
- Department of Laparoscopic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - hui He
- Department of Laparoscopic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
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14
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Belay A, Ali A, Ayele W, Assefa M, Jemal A, Kantelhardt EJ. Incidence and pattern of childhood cancer in Addis Ababa, Ethiopia (2012-2017). BMC Cancer 2023; 23:1261. [PMID: 38129792 PMCID: PMC10734044 DOI: 10.1186/s12885-023-11765-7] [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: 05/08/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Cancer is becoming a major public health problem globally and a leading cause of death in children in developed countries. However, little is known about the epidemiology of childhood cancer in Ethiopia. This study, therefore, assessed childhood cancer incidence patterns in Addis Ababa using the Addis Ababa city population-based cancer registry data from 2012 to 2017. METHODS Invasive cancer cases diagnosed in ages 0-14 years from 2012 to 2017 were obtained from the Addis Ababa City population-based Cancer Registry. Cases were grouped according to the International Classification of Childhood Cancer, 3rd edition (ICCC-3) based on morphology and primary anatomic site. Age-standardized incidence rates (ASR) were calculated by the direct method using the world standard population. RESULTS The overall average annual incidence rate during 2012-2017 in children was 84.6 cases per million, with rates higher in boys (98.97 per million) than in girls (69.7 per million). By age, incidence rates per million increased from 70.8 cases in ages 0-4 years to 88.4 cases in ages 5-9 years to 110.0 cases 10-14 years. Leukaemia was the most common childhood cancer in both boys (29.1%) and girls (26.8%), followed by lymphoma in boys (24.7%) and renal tumours (13.1%) in girls. The overall cancer incidence rate decreased from 87.02 per million in 2012 to 51.07 per million in 2017. CONCLUSION The burden of childhood cancer is considerably high in Addis Ababa. The observed distribution of childhood cancer in Addis Ababa differs from other African countries. This study highlights the need for further research and understanding of the variations in cancer patterns and risk factors across the region.
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Affiliation(s)
- Amanuel Belay
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia.
| | - Ahmed Ali
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondimu Ayele
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Eva J Kantelhardt
- Department of Gynecology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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15
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El Baraka S, Chennaq M, Ouedraogo JM, Cherif Chefchaouni A, Shytry O, Belahcen MJ, Rahali Y. Optimizing chemotherapy medication leftover management circuit in a centralized chemotherapy preparation unit: A comprehensive FMECA risk analysis and continuous improvement approach. J Oncol Pharm Pract 2023:10781552231221450. [PMID: 38111314 DOI: 10.1177/10781552231221450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
OBJECTIVE Chemotherapy medications are usually having high costs, and new targeted drugs can be especially expensive, representing a challenge on healthcare, particularly in low- and middle-income countries. As cytotoxic leftover management is crucial for reducing medication wastage, the aim of this study is to evaluate and optimize leftover management circuit in NIO'S Pharmacy Centralized Chemotherapy Preparation Unit (CCPU) through a Failure Mode, Effects and Criticality Analysis (FMECA), and propose continuous improvement element to enhance the security of the process. METHOD The FMECA were conducted in NIO's CCPU from March to May 2023, then continuous improvement plan was established to enhance the security of the process. The failure modes, their causes, impact, and criticality were assessed through criticality index calculation (CI = severity × frequency × detectability), and the risk concerned safety and effectiveness disruptions in chemotherapy preparation circuit using cytotoxic leftover. RESULTS Leftover management circuits were described in flowchart form, where 18 failure modes were detected in four different steps of the process from chemotherapy preparation to disposal. Failure with highest critical index were detected in the case of equipment malfunction, improper storage temperature, and humidity. Continuous improvement recommendations were proposed in a table form. CONCLUSION FMECA analysis applied to NIO's chemotherapy leftover management process allowed us to evaluate, secure, and optimize the circuit, and to propose several actions to implement in a perspective of continuous improvement.
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Affiliation(s)
- Soumaya El Baraka
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Meryem Chennaq
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Jean-Marie Ouedraogo
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Ali Cherif Chefchaouni
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Oumaima Shytry
- National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco
| | | | - Younes Rahali
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco
- Team of Formulation and Quality Control of Health Products, Faculty of Medicine and Pharmacy, Mohammed V University-Rabat, Rabat, Morocco
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16
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Are C, Murthy SS, Sullivan R, Schissel M, Chowdhury S, Alatise O, Anaya D, Are M, Balch C, Bartlett D, Brennan M, Cairncross L, Clark M, Deo SVS, Dudeja V, D'Ugo D, Fadhil I, Giuliano A, Gopal S, Gutnik L, Ilbawi A, Jani P, Kingham TP, Lorenzon L, Leiphrakpam P, Leon A, Martinez-Said H, McMasters K, Meltzer DO, Mutebi M, Zafar SN, Naik V, Newman L, Oliveira AF, Park DJ, Pramesh CS, Rao S, Subramanyeshwar Rao T, Bargallo-Rocha E, Romanoff A, Rositch AF, Rubio IT, Salvador de Castro Ribeiro H, Sbaity E, Senthil M, Smith L, Toi M, Turaga K, Yanala U, Yip CH, Zaghloul A, Anderson BO. Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide. Lancet Oncol 2023; 24:e472-e518. [PMID: 37924819 DOI: 10.1016/s1470-2045(23)00412-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 11/06/2023]
Abstract
The first Lancet Oncology Commission on Global Cancer Surgery was published in 2015 and serves as a landmark paper in the field of cancer surgery. The Commission highlighted the burden of cancer and the importance of cancer surgery, while documenting the many inadequacies in the ability to deliver safe, timely, and affordable cancer surgical care. This Commission builds on the first Commission by focusing on solutions and actions to improve access to cancer surgery globally, developed by drawing upon the expertise from cancer surgery leaders across the world. We present solution frameworks in nine domains that can improve access to cancer surgery. These nine domains were refined to identify solutions specific to the six WHO regions. On the basis of these solutions, we developed eight actions to propel essential improvements in the global capacity for cancer surgery. Our initiatives are broad in scope, pragmatic, affordable, and contextually applicable, and aimed at cancer surgeons as well as leaders, administrators, elected officials, and health policy advocates. We envision that the solutions and actions contained within the Commission will address inequities and promote safe, timely, and affordable cancer surgery for every patient, regardless of their socioeconomic status or geographic location.
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Affiliation(s)
- Chandrakanth Are
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Shilpa S Murthy
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, King's College London, London, UK
| | - Makayla Schissel
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sanjib Chowdhury
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Olesegun Alatise
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Daniel Anaya
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Madhuri Are
- Division of Pain Medicine, Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Charles Balch
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, Global Cancer Surgery: pragmatic solutions to improve USA
| | - David Bartlett
- Department of Surgery, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - Murray Brennan
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lydia Cairncross
- Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Matthew Clark
- University of Auckland School of Medicine, Auckland, New Zealand
| | - S V S Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Dudeja
- Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Domenico D'Ugo
- Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome, Italy
| | | | - Armando Giuliano
- Cedars-Sinai Medical Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Satish Gopal
- Center for Global Health, National Cancer Institute, Washington DC, USA
| | - Lily Gutnik
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Pankaj Jani
- Department of Surgery, University of Nairobi, Nairobi, Kenya
| | | | - Laura Lorenzon
- Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome, Italy
| | - Premila Leiphrakpam
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Augusto Leon
- Department of Surgical Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Kelly McMasters
- Division of Surgical Oncology, Hiram C Polk, Jr MD Department of Surgery, University of Louisville, Louisville, KY, USA
| | - David O Meltzer
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Syed Nabeel Zafar
- Department of Surgery, University of Wisconsin Hospitals and Clinics, Madison, WI, USA
| | - Vibhavari Naik
- Department of Anesthesiology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Lisa Newman
- Department of Surgery, New York-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | | | - Do Joong Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - C S Pramesh
- Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Saieesh Rao
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - T Subramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | | | - Anya Romanoff
- Department of Global Health and Health System Design, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain
| | | | - Eman Sbaity
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maheswari Senthil
- Division of Surgical Oncology, Department of Surgery, University of California, Irvine, Irvine, CA, USA
| | - Lynette Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Masakazi Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Kiran Turaga
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Ujwal Yanala
- Surgical Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Cheng-Har Yip
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
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Chew NM, Ting EL, Kerr L, Brewster DJ, Russo PL. Psychosocial Interventions at the End-of-Life: A Scoping Review. Cancer Nurs 2023; 46:432-446. [PMID: 35786585 DOI: 10.1097/ncc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The integration of holistic and effective end-of-life (EOL) care into cancer management has increasingly become a recognized field. People living with terminal cancer and their caregivers face a unique set of emotional, spiritual, and social stressors, which may be managed by psychosocial interventions. OBJECTIVES This study aimed to explore the types and characteristics of psychosocial interventions at the EOL for adult cancer patients and their caregivers and to identify gaps in the current literature. METHODS A systematic search was conducted through MEDLINE (Ovid) and CINAHL from January 1, 2011, to January 31, 2021, retrieving 2453 results. A final 15 articles fulfilled the inclusion criteria, reviewed by 2 independent reviewers. Ten percent of the original articles were cross-checked against study eligibility at every stage by 2 experienced researchers. RESULTS Most interventions reported were psychotherapies, with a predominance of meaning or legacy-related psychotherapies. Most interventions were brief, with significant caregiver involvement. Most studies were conducted in high-income, English-speaking populations. CONCLUSION There is robust, although heterogeneous, literature on a range of psychosocial interventions at the EOL. However, inconsistencies in the terminology used surrounding EOL and means of outcome assessment made the comparison of interventions challenging. IMPLICATION FOR PRACTICE Future studies will benefit from increased standardization of study design, EOL terminology, and outcome assessment to allow for a better comparison of intervention efficacy. There is a need for increased research in psychosocial interventions among middle- to low-income populations exploring social aspects, intimacy, and the impact of COVID-19.
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Affiliation(s)
- Nicolle Marie Chew
- Author Affiliations: School of Medicine, Monash University (Drs Chew and Ting); Cabrini Monash University Department of Nursing Research, Cabrini Health (Drs Chew, Ting, Russo, and Kerr); School of Nursing and Midwifery, Monash University (Drs Russo and Kerr); Intensive Care Unit, Cabrini Hospital (Dr Brewster); and Central Clinical School, Monash University (Dr Brewster), Victoria, Australia
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Petrucci B, Okerosi S, Patterson RH, Hobday SB, Salano V, Waterworth CJ, Brody RM, Sprow H, Alkire BC, Fagan JJ, Tamir SO, Der C, Bhutta MF, Maina IW, Pang JC, Daudu D, Mukuzi AG, Srinivasan T, Pietrobon CA, Hao SP, Nakku D, Seguya A, Din TF, Mbougo OD, Mokoh LW, Jashek-Ahmed F, Law TJ, Holt EA, Bangesh AH, Zemene Y, Ibekwe TS, Diallo OR, Alvarado J, Mulwafu WK, Fenton JE, Agius AM, Doležal P, Mudekereza ÉA, Mojica KM, Rueda RS, Xu MJ. The Global Otolaryngology-Head and Neck Surgery Workforce. JAMA Otolaryngol Head Neck Surg 2023; 149:904-911. [PMID: 37651133 PMCID: PMC10472262 DOI: 10.1001/jamaoto.2023.2339] [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: 02/26/2023] [Accepted: 06/25/2023] [Indexed: 09/01/2023]
Abstract
Importance A core component of delivering care of head and neck diseases is an adequate workforce. The World Health Organization report, Multi-Country Assessment of National Capacity to Provide Hearing Care, captured primary workforce estimates from 68 member states in 2012, noting that response rates were a limitation and that updated more comprehensive data are needed. Objective To establish comprehensive workforce metrics for global otolaryngology-head and neck surgery (OHNS) with updated data from more countries/territories. Design, Setting, and Participants A cross-sectional electronic survey characterizing the OHNS workforce was disseminated from February 10 to June 22, 2022, to professional society leaders, medical licensing boards, public health officials, and practicing OHNS clinicians. Main Outcome The OHNS workforce per capita, stratified by income and region. Results Responses were collected from 121 of 195 countries/territories (62%). Survey responses specifically reported on OHNS workforce from 114 countries/territories representing 84% of the world's population. The global OHNS clinician density was 2.19 (range, 0-61.7) OHNS clinicians per 100 000 population. The OHNS clinician density varied by World Bank income group with higher-income countries associated with a higher density of clinicians. Regionally, Europe had the highest clinician density (5.70 clinicians per 100 000 population) whereas Africa (0.18 clinicians per 100 000 population) and Southeast Asia (1.12 clinicians per 100 000 population) had the lowest. The OHNS clinicians deliver most of the surgical management of ear diseases and hearing care, rhinologic and sinus diseases, laryngeal disorders, and upper aerodigestive mucosal cancer globally. Conclusion and Relevance This cross-sectional survey study provides a comprehensive assessment of the global OHNS workforce. These results can guide focused investment in training and policy development to address disparities in the availability of OHNS clinicians.
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Affiliation(s)
| | - Samuel Okerosi
- Ear Nose and Throat Department, Kenyatta National Hospital, Nairobi, Kenya
| | - Rolvix H. Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Sara B. Hobday
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Valerie Salano
- Ear Nose and Throat Department, Nyahururu County Hospital, Nyahururu, Kenya
| | - Christopher J. Waterworth
- Nossal Institute for Global Health, Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Robert M. Brody
- Department of Otorhinolaryngology–Head & Neck Surgery, University of Pennsylvania, Philadelphia
| | - Holly Sprow
- Tufts University School of Medicine, Boston, Massachusetts
| | - Blake C. Alkire
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston
| | - Johannes J. Fagan
- Division of Otolaryngology, University of Cape Town, Cape Town, South Africa
| | - Sharon Ovnat Tamir
- Department of Otolaryngology/Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University of the Negev, Israel
| | - Carolina Der
- Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana de Santiago, Hospital Dr Luis Calvo Mackenna, Chile
| | | | - Ivy W. Maina
- Department of Otorhinolaryngology–Head & Neck Surgery, University of Pennsylvania, Philadelphia
| | - Jonathan C. Pang
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine
| | - Davina Daudu
- Faculty of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Allan G. Mukuzi
- Department of Otorhinolaryngology Head and Neck Surgery, University of Nairobi, Kenya
| | | | | | - Sheng-Po Hao
- Department of Otolaryngology Head and Neck Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Fu-Jen University, Taiwan
| | - Doreen Nakku
- Department of Otolaryngology Head and Neck Surgery, Mbarara University of Science and Technology, Uganda
| | - Amina Seguya
- Department of Otolaryngology Head and Neck Surgery, Mulago National Referral Hospital, Uganda
| | - Taseer F. Din
- Division of Pediatric Otolaryngology, Head-Neck Surgery, Department of Otolaryngology, Head-Neck Surgery, Stanford University, Stanford, California
| | | | - Lilian W. Mokoh
- Kenyatta University Teaching Research and Referral Hospital, Nairobi, Kenya
| | - Farizeh Jashek-Ahmed
- The International Center for Recurrent Head and Neck Cancer, the Royal Marsden Hospital, London, United Kingdom
| | - Tyler J. Law
- Department of Anesthesia & Perioperative Care, University of California, San Francisco
| | - Elizabeth A. Holt
- The Eisdell Moore Centre for Hearing and Balance Research, The University of Auckland, Auckland, New Zealand
| | | | - Yilkal Zemene
- St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Titus S. Ibekwe
- University of Abuja and University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | | | - Wakisa K. Mulwafu
- Department of Surgery, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - John E. Fenton
- Department of Otorhinlaryngology–Head and Neck Surgery, University of Limerick, Limerick, Ireland
| | - Adrian M. Agius
- Department of Otorhinolaryngology, University of Malta, Malta
| | - Pavel Doležal
- Department of Otorhinolaryngology and Head and Neck Surgery, Slovak Medical University, Bratislava, Slovakia
| | - Édouard Amani Mudekereza
- Hôpital Provincial Général de Référence de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Karen M. Mojica
- Department of otolaryngology, Vivian Pellas Hospital, Managua, Nicaragua
| | - Ricardo Silva Rueda
- Servicio de Otorrinolaringología, Bogota, Hospital Militar Central, Bogata, Colombia
| | - Mary Jue Xu
- Department of Anesthesia & Perioperative Care, University of California, San Francisco
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco
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Ju W, Zheng R, Wang S, Zhang S, Zeng H, Chen R, Sun K, Li L, Wei W. The occurence of cancer in ageing populations at global and regional levels, 1990 to 2019. Age Ageing 2023; 52:afad043. [PMID: 37725972 DOI: 10.1093/ageing/afad043] [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: 05/05/2022] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND population ageing contributes to increased cancer cases and deaths and has profound implications for global healthcare systems. We estimated the trends of cancer cases and deaths in ageing populations at global and regional levels. METHODS using data from the Global Burden of Disease Study 2019, we analysed the change in cancer cases and deaths associated with population ageing, population growth and epidemiological factors from 1990 to 2019 using decomposition analysis. Additionally, we estimated the proportions of people aged 65 years and over accounting for total cases and deaths, and investigated relationships between the proportions and the Sociodemographic Index (SDI) using the Pearson correlation coefficient. RESULTS from 1990 to 2019, there was an increase of 128.9% for total cases and 74.8% for total deaths in all cancers combined; the percentages of older people increased from 48.6% to 56.4% for cases and from 52.0% to 61.9% for deaths. Population ageing contributed to the largest increase in global cancer occurrence, with 56.5% for cases and 63.3% for deaths. However, the changes attributed to epidemiological factors was 5.2% for cancer cases and -33.4% for cancer deaths. The proportions of total cases and deaths of older adults were positively correlated with socioeconomic development of the country. CONCLUSION our findings revealed that the main contributor to increased cancer cases and deaths has changed from comprehensive epidemiological factors to demographic shifts. To respond to the rapidly growing occurrence of cancer in ageing populations, the global health priority should focus on meeting the rising demand for cancer diagnosis, treatment and care services for older people.
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Affiliation(s)
- Wen Ju
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaoming Wang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Siwei Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ru Chen
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kexin Sun
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Li
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Jaffray DA, Knaul F, Baumann M, Gospodarowicz M. Harnessing progress in radiotherapy for global cancer control. NATURE CANCER 2023; 4:1228-1238. [PMID: 37749355 DOI: 10.1038/s43018-023-00619-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/22/2023] [Indexed: 09/27/2023]
Abstract
The pace of technological innovation over the past three decades has transformed the field of radiotherapy into one of the most technologically intense disciplines in medicine. However, the global barriers to access this highly effective treatment are complex and extend beyond technological limitations. Here, we review the technological advancement and current status of radiotherapy and discuss the efforts of the global radiation oncology community to formulate a more integrative 'diagonal approach' in which the agendas of science-driven advances in individual outcomes and the sociotechnological task of global cancer control can be aligned to bring the benefit of this proven therapy to patients with cancer everywhere.
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Affiliation(s)
- David A Jaffray
- Departments of Radiation Physics and Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Felicia Knaul
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | - Mary Gospodarowicz
- Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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21
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Zhou Y, Naci H, Chen D, Bai L, Shi L, Guan X, Wagner AK. Overall survival benefits of cancer drugs in the WHO Model List of Essential Medicines, 2015-2021. BMJ Glob Health 2023; 8:e012899. [PMID: 37775106 PMCID: PMC10546158 DOI: 10.1136/bmjgh-2023-012899] [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: 05/19/2023] [Accepted: 09/09/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION We examined overall survival (OS) benefits for targeted cancer drugs recommended for List of Essential Medicines (EMLs) since 2015. We assessed consistency of decisions in 2019 and 2021 with more specific criteria: OS benefit >4 months and high scores on European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS). METHODS We identified applications for cancer drug in WHO EMLs from 2015 to 2021. We extracted evidence of OS benefit documented in WHO Technical Report Series (TRS) and compared it to evidence from pivotal trial(s) documented in Food and Drug Administration-approved labels. We retrieved published ESMO-MCBS scores. We summarised availability and magnitude of OS benefit and ESMO-MCBS scores and assessed consistency of inclusion decisions against WHO criteria. RESULTS 22/54 targeted cancer drug indications were recommended. Among them, 68.2% and 31.8% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Among those not recommended, 59.4% and 56.3% had OS benefit evidence documented in WHO-TRS and pivotal trials, respectively. Of 11 cancer drug indications recommended in 2019 and 2021, 54.5% and 9.1% had evidence of OS benefit >4 months in WHO-TRS and pivotal trials, respectively; 45.5% met ESMO-MCBS criteria. Ten targeted cancer drugs had more than one application for the same indications. Five of those were eventually recommended, including three without new evidence of OS benefit. Additional factors, such as reduced cost, and increased treatment options, seemed to be important factors in the selection. CONCLUSION While WHO has defined approval criteria for cancer drugs EML, we identified areas where adherence of these criteria and communication of the EML approval decision-making processes can be improved.
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Affiliation(s)
- Yue Zhou
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
| | - Huseyin Naci
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Dingyi Chen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Lin Bai
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Luwen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Xiaodong Guan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Anita Katharina Wagner
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Kothari K, Damoi JO, Zeizafoun N, Asiimwe P, Glerum K, Bakaleke M, Giibwa A, Umphlett M, Marin M, Zhang LP. Increasing access to pathology services in low- and middle-income countries through innovative use of telepathology. Surg Endosc 2023; 37:7206-7211. [PMID: 37365395 DOI: 10.1007/s00464-023-10220-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION In low- and middle-income countries (LMICs), surgical care can be limited by access to pathology services. In Uganda, the pathologist-to-population ratio is less than 1 to 1 million people. The Kyabirwa Surgical Center in Jinja, Uganda, created a telepathology service in collaboration with an academic institution in New York City. This study demonstrated the feasibility and considerations of implementing a telepathology model to supplement the critical pathology needs of a low-income country. METHODS This was a retrospective, single-center study of an ambulatory surgery center with pathology capability using virtual microscopy. The remote pathologist (also known as a telepathologist) controlled the microscope and reviewed histology images transmitted across the network in real time. In addition, this study collected demographics, clinical histories, the surgeon's preliminary diagnoses, and the pathology reports from the center's electronic medical record. RESULTS Nikon's NIS Element Software was used as a dynamic, robotic microscopy model with a video conferencing platform for communication. An underground fiber optic cable established Internet connectivity. After a two-hour tutorial session, the lab technician and pathologist were able to proficiently use the software. The remote pathologist read (1) pathology slides with inconclusive reports from external pathology labs, and (2) tissues labeled by the surgeon as suspicious for malignancy, which belonged to patients who lacked financial means for pathology services. Between April 2021 and July 2022, tissue samples of 110 patients were examined by a telepathologist. The most common malignancies on histology were squamous cell carcinoma of the esophagus, ductal carcinoma of the breast, and colorectal adenocarcinoma. CONCLUSION With the increasing availability of video conference platforms and network connections, telepathology is an emerging field that can be used by surgeons in LMICs to improve access to pathology services, confirming histological diagnosis of malignancies to ensure appropriate treatment.
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Affiliation(s)
- Krsna Kothari
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA.
| | | | - Nebras Zeizafoun
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | | | - Katie Glerum
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | | | | | - Melissa Umphlett
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Michael Marin
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
| | - Linda P Zhang
- Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA
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Court L, Aggarwal A, Burger H, Cardenas C, Chung C, Douglas R, du Toit M, Jaffray D, Jhingran A, Mejia M, Mumme R, Muya S, Naidoo K, Ndumbalo J, Nealon K, Netherton T, Nguyen C, Olanrewaju N, Parkes J, Shaw W, Trauernicht C, Xu M, Yang J, Zhang L, Simonds H, Beadle BM. Addressing the Global Expertise Gap in Radiation Oncology: The Radiation Planning Assistant. JCO Glob Oncol 2023; 9:e2200431. [PMID: 37471671 PMCID: PMC10581646 DOI: 10.1200/go.22.00431] [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: 12/18/2022] [Revised: 02/08/2023] [Accepted: 04/24/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE Automation, including the use of artificial intelligence, has been identified as a possible opportunity to help reduce the gap in access and quality for radiotherapy and other aspects of cancer care. The Radiation Planning Assistant (RPA) project was conceived in 2015 (and funded in 2016) to use automated contouring and treatment planning algorithms to support the efforts of oncologists in low- and middle-income countries, allowing them to scale their efforts and treat more patients safely and efficiently (to increase access). DESIGN In this review, we discuss the development of the RPA, with a particular focus on clinical acceptability and safety/risk across jurisdictions as these are important indicators for the successful future deployment of the RPA to increase radiotherapy availability and ameliorate global disparities in access to radiation oncology. RESULTS RPA tools will be offered through a webpage, where users can upload computed tomography data sets and download automatically generated contours and treatment plans. All interfaces have been designed to maximize ease of use and minimize risk. The current version of the RPA includes automated contouring and planning for head and neck cancer, cervical cancer, breast cancer, and metastases to the brain. CONCLUSION The RPA has been designed to bring high-quality treatment planning to more patients across the world, and it may encourage greater investment in treatment devices and other aspects of cancer treatment.
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Affiliation(s)
- Laurence Court
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ajay Aggarwal
- Guy's and St Thomas' Hospital, London, United Kingdom
| | - Hester Burger
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | | | - Christine Chung
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Raphael Douglas
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Monique du Toit
- Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - David Jaffray
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anuja Jhingran
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Mejia
- Benavides Cancer Institute, University of Santo Tomas, Manila, Philippines
| | - Raymond Mumme
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Komeela Naidoo
- Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | | | - Kelly Nealon
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Niki Olanrewaju
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeannette Parkes
- Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Willie Shaw
- University of the Free State, Bloemfontein, South Africa
| | | | - Melody Xu
- University of California San Francisco, San Francisco, CA
| | - Jinzhong Yang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lifei Zhang
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Olteanu GE, Oancea CI, Catalin M, Trifa AP, Dascalu S. Addressing the unmet need for a comprehensive lung cancer registry in Romania. Front Oncol 2023; 13:1211533. [PMID: 37388228 PMCID: PMC10303923 DOI: 10.3389/fonc.2023.1211533] [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] [Received: 04/24/2023] [Accepted: 06/01/2023] [Indexed: 07/01/2023] Open
Abstract
In this perspective article, we describe the vital need for a well-organized cancer registry in Romania, where lung cancer prevalence and mortality rates are alarmingly high. We discuss contributing factors such as increased use of chest X-rays and CT scans during the COVID-19 pandemic and delayed diagnoses due to limited medical care access. With the nation's characteristically limited access to healthcare, it is plausible that the surge in acute imaging for COVID-19 has inadvertently resulted in a higher detection rate of lung cancer. This inadvertent early detection underscores the vital need for a well-organized cancer registry in Romania, where lung cancer prevalence and mortality rates are alarmingly high. Although impactful, these factors are not the primary causes of the high lung cancer cases in the country. We provide an overview of current options and propose future perspectives for epidemiological monitoring of lung cancer patients in Romania, aiming to enhance patient care, bolster research, and promote data-driven policy-making. While our primary focus is establishing a national registry for lung cancer, we address challenges, considerations, and best practices applicable to all cancer types. Through our proposed strategies and recommendations, we aim to contribute to the development and improvement of a comprehensive national cancer registry system in Romania.
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Affiliation(s)
- Gheorghe-Emilian Olteanu
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases. Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center of Expertise for Rare Lung Diseases, Clinical Hospital of Infectious Diseases and Pneumophthisiology “Dr. Victor Babes” Timisoara, Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristian Iulian Oancea
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases. Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center of Expertise for Rare Lung Diseases, Clinical Hospital of Infectious Diseases and Pneumophthisiology “Dr. Victor Babes” Timisoara, Timisoara, Romania
| | - Marian Catalin
- The Discipline of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Adrian Pavel Trifa
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases. Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- The Discipline of Genetics, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Genetics, Clinical Hospital of Infectious Diseases and Pneumophthisiology “Dr. Victor Babes” Timisoara, Timisoara, Romania
- Department of Genetics, Oncological Institute “Prof. Dr. Ion Chiricuta” Cluj-Napoca, Cluj-Napoca, Romania
| | - Stefan Dascalu
- Department of Biology, University of Oxford, Oxford, United Kingdom
- Dig Worldwide Ltd, Discovery Park, Sandwich, United Kingdom
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Schroeder KM, Rizzieri T, Lion RR, Mtenga N, Gisiri M, McFatrich M, Reeve BB. Swahili translation and cultural adaptation of the pediatric patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Patient Rep Outcomes 2023; 7:56. [PMID: 37306774 PMCID: PMC10260717 DOI: 10.1186/s41687-023-00598-4] [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: 02/09/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The pediatric patient-reported outcomes version of the common terminology criteria for adverse event measure was developed and validated for use in pediatric cancer clinical trials to better capture the symptom experiences through direct self-report. The study aim was to develop and validate a Swahili language version of the patient-reported outcomes version of the common terminology criteria for adverse event measure. METHODS The pediatric version of 15 core symptom adverse events, and the corresponding questions, were selected from the patient-reported outcomes version of the common terminology criteria for adverse event library, then forward and back translated into Swahili by bilingual translators. The translated items were further refined using concurrent cognitive interviewing. Each round of interviews included five children, ages 8-17 years-old, receiving cancer therapy at Bugando Medical Centre, the cancer referral hospital for Northwest Tanzania, and continued until at least 80% of participants understood the question. RESULTS Three rounds of cognitive interviews were completed involving 13 patients and 5 caregivers. Among patients, 50% of questions (19/38) were fully comprehended after the first interview round. Two Adverse Events (anxiety and peripheral neuropathy) were the most difficult for participants to understand, associated with education level and experience. Goal comprehension was achieved after three rounds of interviews with no further revisions required. All parents in the first cognitive interview group comprehended the survey, with no additional revisions. CONCLUSION A Swahili patient-reported outcomes version of the common terminology criteria for adverse event was effective in eliciting patient-reported Adverse Events related to cancer treatment, with good comprehension for children aged 8-17 years. This survey is important to incorporate patient self-reporting of symptomatic toxicities and is an effective tool to increase capacity for pediatric cancer clinical trials throughout East Africa, further reducing global disparities in cancer care.
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Affiliation(s)
| | | | | | | | | | | | - Bryce B Reeve
- Duke Department of Population Health Sciences, Durham, USA
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Ganesan P, El Cheikh J, Isidori A, Kuo SH, Saleh M, Nair R. Editorial: The management of hematologic malignancies in lower-income countries. Front Oncol 2023; 13:1218718. [PMID: 37284195 PMCID: PMC10240044 DOI: 10.3389/fonc.2023.1218718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
- Prasanth Ganesan
- Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Jean El Cheikh
- Department of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alessandro Isidori
- Hematology and Stem Cell Transplant Center, Marche Norde Hospital, Pesaro, Italy
| | - Sung-Hsin Kuo
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mustafa Saleh
- Department of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Reena Nair
- Clinical Haematology Oncology and Hematopoietic Cell Transplantation (HCT), Tata Medical Centre, Kolkata, India
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Fan Y, Jiang Y, Gong L, Wang Y, Su Z, Li X, Wu H, Pan H, Wang J, Meng Z, Zhou Q, Qiao Y. Epidemiological and demographic drivers of lung cancer mortality from 1990 to 2019: results from the global burden of disease study 2019. Front Public Health 2023; 11:1054200. [PMID: 37213644 PMCID: PMC10196253 DOI: 10.3389/fpubh.2023.1054200] [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: 09/26/2022] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Background Understanding the effects of demographic drivers on lung cancer mortality trends is critical for lung cancer control. We have examined the drivers of lung cancer mortality at the global, regional, and national levels. Methods Data on lung cancer death and mortality were extracted from the Global Burden of Disease (GBD) 2019. Estimated annual percentage change (EAPC) in the age-standardized mortality rate (ASMR) for lung cancer and all-cause mortality were calculated to measure temporal trends in lung cancer from 1990 to 2019. Decomposition analysis was used to analyze the contributions of epidemiological and demographic drivers to lung cancer mortality. Results Despite a non-significant decrease in ASMR [EAPC = -0.31, 95% confidence interval (CI): -1.1 to 0.49], the number of deaths from lung cancer increased by 91.8% [95% uncertainty interval (UI): 74.5-109.0%] between 1990 and 2019. This increase was due to the changes in the number of deaths attributable to population aging (59.6%), population growth (56.7%), and non-GBD risks (3.49%) compared with 1990 data. Conversely, the number of lung cancer deaths due to GBD risks decreased by 19.8%, mainly due to tobacco (-12.66%), occupational risks (-3.52%), and air pollution (-3.47%). More lung cancer deaths (1.83%) were observed in most regions, which were due to high fasting plasma glucose levels. The temporal trend of lung cancer ASMR and the patterns of demographic drivers varied by region and gender. Significant associations were observed between the contributions of population growth, GBD risks and non-GBD risks (negative), population aging (positive), and ASMR in 1990, the sociodemographic index (SDI), and the human development index (HDI) in 2019. Conclusion Population aging and population growth increased global lung cancer deaths from 1990 to 2019, despite a decrease in age-specific lung cancer death rates due to GBD risks in most regions. A tailored strategy is needed to reduce the increasing burden of lung cancer due to outpacing demographic drivers of epidemiological change globally and in most regions, taking into account region- or gender-specific risk patterns.
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Affiliation(s)
- Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Yong Jiang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Gong
- Department of Esophageal Cancer, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Ying Wang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zheng Su
- Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xuebing Li
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Heng Wu
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongli Pan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Wang
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qinghua Zhou
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
- Sichuan Lung Cancer Institute, Sichuan Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Center of Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Erukainure OL, Oyenihi OR, Amaku JF, Chukwuma CI, Nde AL, Salau VF, Matsabisa MG. Cannabis sativa L. modulates altered metabolic pathways involved in key metabolisms in human breast cancer (MCF-7) cells: A metabolomics study. Heliyon 2023; 9:e16156. [PMID: 37215911 PMCID: PMC10196869 DOI: 10.1016/j.heliyon.2023.e16156] [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: 01/24/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
The present study investigated the ability of Cannabis sativa leaves infusion (CSI) to modulate major metabolisms implicated in cancer cells survival, as well as to induce cell death in human breast cancer (MCF-7) cells. MCF-7 cell lines were treated with CSI for 48 h, doxorubicin served as the standard anticancer drug, while untreated MCF-7 cells served as the control. CSI caused 21.2% inhibition of cell growth at the highest dose. Liquid chromatography-mass spectroscopy (LC-MS) profiling of the control cells revealed the presence of carbohydrate, vitamins, oxidative, lipids, nucleotides, and amino acids metabolites. Treatment with CSI caused a 91% depletion of these metabolites, while concomitantly generating selenomethionine, l-cystine, deoxyadenosine triphosphate, cyclic AMP, selenocystathionine, inosine triphosphate, adenosine phosphosulfate, 5'-methylthioadenosine, uric acid, malonic semialdehyde, 2-methylguanosine, ganglioside GD2 and malonic acid. Metabolomics analysis via pathway enrichment of the metabolites revealed the activation of key metabolic pathways relevant to glucose, lipid, amino acid, vitamin, and nucleotide metabolisms. CSI caused a total inactivation of glucose, vitamin, and nucleotide metabolisms, while inactivating key lipid and amino acid metabolic pathways linked to cancer cell survival. Flow cytometry analysis revealed an induction of apoptosis and necrosis in MCF-7 cells treated with CSI. High-performance liquid chromatography (HPLC) analysis of CSI revealed the presence of cannabidiol, rutin, cinnamic acid, and ferulic. These results portray the antiproliferative potentials of CSI as an alternative therapy for the treatment and management of breast cancer as depicted by its modulation of glucose, lipid, amino acid, vitamin, and nucleotide metabolisms, while concomitantly inducing cell death in MCF-7 cells.
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Affiliation(s)
- Ochuko L. Erukainure
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Omolola R. Oyenihi
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - James F. Amaku
- Department of Chemistry, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria
| | - Chika I. Chukwuma
- Center for Quality of Health and Living, Faculty of Health Sciences, Central University of Technology, Bloemfontein 9301, South Africa
| | - Adeline Lum Nde
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Veronica F. Salau
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Motlalepula G. Matsabisa
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
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Oldfield LE, Jones V, Gill B, Kodous N, Fazelzad R, Rodin D, Sandhu H, Umakanthan B, Papadakos J, Giuliani ME. Synthesis of Existent Oncology Curricula for Primary Care Providers: A Scoping Review With a Global Equity Lens. JCO Glob Oncol 2023; 9:e2200298. [PMID: 37141562 DOI: 10.1200/go.22.00298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
PURPOSE Global increases in cancer, coupled with a shortage of cancer specialists, has led to an increasing role for primary care providers (PCP) in cancer care. This review aimed to examine all extant cancer curricula for PCPs and to analyze the motivations for curriculum development. METHODS A comprehensive literature search was conducted from inception to October 13, 2021, with no language restrictions. The initial search yielded 11,162 articles and 10,902 articles underwent title and abstract review. After full-text review, 139 articles were included. Numeric and thematic analyses were conducted and education programs were evaluated using Bloom's taxonomy. RESULTS Most curricula were developed in high-income countries (HICs), with 58% in the United States. Cancer-specific curricula focused on HIC priority cancers, such as skin/melanoma, and did not represent the global cancer burden. Most (80%) curricula were developed for staff physicians and 73% focused on cancer screening. More than half (57%) of programs were delivered in person, with a shift toward online delivery over time. Less than half (46%) of programs were codeveloped with PCPs and 34% did not involve PCPs in the program design and development. Curricula were primarily developed to improve cancer knowledge, and 72 studies assessed multiple outcome measures. No studies included the top two levels of Bloom's taxonomy of learning (evaluating; creating). CONCLUSION To our knowledge, this is the first review to assess the current state of cancer curricula for PCPs with a global focus. This review shows that extant curricula are primarily developed in HICs, do not represent the global cancer burden, and focus on cancer screening. This review lays a foundation to advance the cocreation of curricula that are aligned to the global cancer burden.
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Affiliation(s)
| | - Vivien Jones
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Bhajan Gill
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Nardeen Kodous
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Rouhi Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Danielle Rodin
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Ben Umakanthan
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Janet Papadakos
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
- The Institute for Education Research, University Health Network, Toronto, ON, Canada
| | - Meredith Elana Giuliani
- Cancer Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
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Saunders AC, Mutebi M, Rao TS. A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution. Ann Surg Oncol 2023; 30:3197-3205. [PMID: 36973564 PMCID: PMC10175401 DOI: 10.1245/s10434-023-13352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 03/29/2023]
Abstract
AbstractWorldwide, the capacity of healthcare systems and physician workforce is woefully inadequate for the surgical treatment of cancer. With major projected increases in the global burden of neoplastic disease, this inadequacy is expected to worsen, and interventions to increase the workforce of surgeons who treat cancer and strengthen the necessary supporting infrastructure, equipment, staffing, financial and information systems are urgently called for to prevent this inadequacy from deepening. These efforts must also occur in the context of broader healthcare systems strengthening and cancer control plans, including prevention, screening, early detection, safe and effective treatment, surveillance, and palliation. The cost of these interventions should be considered a critical investment in healthcare systems strengthening that will contribute to improvement in the public and economic health of nations. Failure to act should be seen as a missed opportunity, at the cost of lives and delayed economic growth and development. Surgeons who treat cancer must engage with a diverse array of stakeholders in efforts to address this critical need and are indispensably positioned to participate in collaborative approaches to influence these efforts through research, advocacy, training, and initiatives for sustainable development and overall systems strengthening.
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Affiliation(s)
| | | | - T Subramanyeshwar Rao
- Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
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Mitwalli S, Hammoudeh W, Giacaman R, Harding R. Access to advanced cancer care services in the West Bank-occupied Palestinian territory. Front Oncol 2023; 13:1120783. [PMID: 37007067 PMCID: PMC10062449 DOI: 10.3389/fonc.2023.1120783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionUniversal Health Coverage (UHC) identifies the provision of palliative care for people with advanced disease as an essential health service. Palliative care is also stipulated as a human right under existing covenants. Oncology services provided by the Palestinian Authority under Israeli military occupation are limited to surgery and chemotherapy treatment. Our study aimed to describe the experiences of patients with advanced-stage cancer in the West Bank in accessing oncology services and meeting their health care needs.MethodologyWe conducted a qualitative study among adult patients diagnosed with advanced lung, colon, or breast cancer in three Palestinian governmental hospitals, and with oncologists. Thematic analysis was conducted on the verbatim interview transcripts.ResultsThe sample consisted of 22 Palestinian patients (10 men and 12 women) and 3 practicing oncologists. The findings reveal that cancer care is fragmented, with limited access to the services needed. Patients face referral delays in accessing treatment which worsen their health condition in some cases. Some patients reported difficulties in getting Israeli permits to access radiotherapy treatment in East-Jerusalem, and others experienced interruptions of their chemotherapy treatment sessions due to the unavailability of chemotherapy medications caused by Israeli-side delays. Other reported problems were related to the Palestinian health system and service delivery and quality, including fragmentation of services, infrastructure issues, and unavailability of medications. Advanced diagnostic services and palliative care are almost absent at Palestinian governmental hospitals, and patients need to seek these services in the private sector.ConclusionThe data demonstrate specific access restrictions to cancer care in the West Bank due to Israeli military occupation of Palestinian land. This affects all stages of the care pathway, from restricted diagnosis services, to limited treatment and then poor availability of palliative care. Cancer patients will continue to suffer if the root causes of these structural constraints are not addressed.
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Affiliation(s)
- Suzan Mitwalli
- Institute of Community and Public Health, Birzeit University, West Bank, Palestine
- *Correspondence: Suzan Mitwalli,
| | - Weeam Hammoudeh
- Institute of Community and Public Health, Birzeit University, West Bank, Palestine
| | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, West Bank, Palestine
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, London, United Kingdom
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Franco P, De Felice F, Kaidar-Person O, Gabrys D, Marta GN, Banini M, Livi L, Jagsi R, Coles CE, Poortmans P, Meattini I. Equity, Diversity, and Inclusion in Radiation Oncology: A Bibliometric Analysis and Critical Review. Int J Radiat Oncol Biol Phys 2023; 116:232-245. [PMID: 36841344 DOI: 10.1016/j.ijrobp.2023.02.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
The promotion of equity, diversity, and inclusion (EDI) is being increasingly pursued in health care, both in general and within radiation oncology. Because bibliometrics is a powerful tool to reveal the scientific literature on a specific topic during a certain timespan, a systematic bibliometric analysis of the documents published on EDI in radiation oncology was performed, aiming at exploring common patterns in research and emerging trends, tracking collaborations and networks, and anticipating future directions in clinical research. Standard descriptive statistics and bibliometric techniques were used in the analysis. A collaboration network and thematic map were generated from the data. Four domains were represented: (1) motor themes, including themes well developed and important for the structuring of the research field; (2) niche themes, representing the isolated topics that do not share important external links with other themes; (3) emerging themes, referring to still weakly developed topics; and (4) basic themes, including the essential topics. EDI in the profession of radiation oncology is essential to ensure that the workforce delivering radiation oncology care both draws from the full talent pool of human capital and delivers the highest quality science and clinical care to all patients. The burgeoning literature on EDI in radiation oncology suggests that a large and growing cohort of scholars within radiation oncology are dedicated to addressing these important challenges.
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Affiliation(s)
- Pierfrancesco Franco
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Novara, Italy; Department of Radiation Oncology, Maggiore della Carità University Hospital, Novara, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Orit Kaidar-Person
- Breast Cancer Radiation Therapy Unit, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Dorota Gabrys
- Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo/Brasília, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
| | - Marco Banini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | | | - Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
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Akinwande AM, Ugwuanyi DC, Chiegwu HU, Idigo F, Ogolodom MP, Anakwenze CP, Abi R, Odukoya O. Radiotherapy services in low resource settings: The situation in Nigeria. SAGE Open Med 2023; 11:20503121231153758. [PMID: 36778199 PMCID: PMC9909043 DOI: 10.1177/20503121231153758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/12/2023] [Indexed: 02/10/2023] Open
Abstract
Objective About 50%-60% of all cancer cases will require radiotherapy during their treatment. Nonetheless, radiotherapy facilities are limited in low- and middle-income countries and despite high cancer burden in these regions of the world, only 5% have access to radiation therapy. This study identified the location of radiotherapy centers, the types of radiotherapy machines available and the personnel available in each radiotherapy center in Nigeria. Methods A cross-sectional questionnaire-based study conducted across the six geopolitical zones of Nigeria from May 2020 to April 2021. A questionnaire having sections on facility profile, status of facility, and human resources, was used to elucidate information for the study. Descriptive statistics (frequency and proportion) were used to describe facilities' characteristics, status, and human resources available. Results Out of nine radiotherapy centers evaluated, the majority 33.3% (n = 3) were found in the southwest geopolitical zone of Nigeria. Out of 10 equipment and accessories evaluated for availability, Ahmadu Bello University Teaching Hospital and University of Benin Teaching Hospital had the highest number of available equipment and accessories 90% (n = 9) each respectively. Out of the nine centers evaluated, only four centers had at least one functional equipment. The highest number 64.3% (n = 9) out of the 14 required number of staff in each center was found at University College Hospital. Out of 31 medical physicists identified, the majority 22.6% (n = 7) was found at University of Nigeria Teaching Hospital. Conclusion A high percentage of radiotherapy centers in Nigeria lacks the equipment and manpower to function optimally and is located within the southwest geopolitical zone of Nigeria. Therefore, proper investment in the radiotherapy service through private-public partnership, staff training, and equipment upgrade and maintenance could substantially improve the state of cancer care.
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Affiliation(s)
- Abidoye Matthew Akinwande
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria,Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria,Department of Radiography and Radiation Science, Lead City University, Ibadan, Nigeria,Abidoye Matthew Akinwande, Department of Radiation Oncology, University College Hospital, Queen Elizabeth Road, P.M.B. 5116, Ibadan, Oyo state 200211, Nigeria.
| | - Daniel Chimuanya Ugwuanyi
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Hyacienth Uche Chiegwu
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Felicitas Idigo
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria,Department of Medical Radiography and Radiological Sciences, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Michael Promise Ogolodom
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Roland Abi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwaponmile Odukoya
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Monárrez‐Espino J, Romero‐Rodriguez L, Escamilla‐Asiain G, Ellis‐Irigoyen A, Cubría‐Juárez MDP, Sematimba D, Rodríguez‐Galindo C, Vega‐Vega L. Survival estimates of childhood malignancies treated at the Mexican telethon pediatric oncology hospital. Cancer Rep (Hoboken) 2023; 6:e1702. [PMID: 36054813 PMCID: PMC9939997 DOI: 10.1002/cnr2.1702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pediatric cancer incidence in Mexico is ~160/million/year with leukemias making 49.8% of the cases. While survival rates have been reported in various Mexican studies, no data is available from the Telethon Pediatric Oncology Hospital-HITO, a nonprofit private institution specialized exclusively in comprehensive pediatric oncology care in the country that closely follows high-income countries' advanced standards of cancer care. AIM To determine overall survival (OS) and relapse-free survival (RFS) in patients treated at HITO between December 2013 and February 2018. METHODS AND RESULTS Secondary analysis of data extracted from medical records. It included 286 children aged 0-17 years diagnosed with various cancers grouped into three categories based on location: (1) Acute lymphoblastic leukemia (ALL), (2) tumors within the central nervous system (TWCNS), and (3) tumors outside the CNS (TOCNS). OS and RFS rates for patients who completed 1 (n = 230) and 3 (n = 132) years of follow-up after admission were computed by sex, age, and cancer location, and separately for a subsample (1-year = 191, 3-years = 110) who fulfilled the HITO criteria (no prior treatment, underwent surgery/chemotherapy when indicated, and initiated therapy). TOCNS accounted for 45.1%, but ALL was the most frequent single diagnosis with 28%. Three-year OS for patients with ALL, TWCNS, and TOCNS who fulfilled the HITO criteria were 91.9%, 86.7%, and 79.3%, respectively; for 3-year RFS these were 89.2%, 60%, and 72.4%. Boys showed slightly higher OS and RFS, but no major differences or trends were seen by age group. CONCLUSION This study sets a relevant reference in terms of survival and relapse for children with cancer in Mexico treated at a private oncology center that uses a comprehensive and integrated therapeutic model.
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Affiliation(s)
- Joel Monárrez‐Espino
- Department of Health Research, Christus Muguerza del Parque HospitalUniversity of MonterreyChihuahuaMexico
- PhD Program in Molecular Medicine, Human Medicine and Health Sciences Academic UnitZacatecas Autonomous UniversityZacatecasMexico
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Molla MD, Wolde HF, Tafesse Teferi E, Kibret AA. Central obesity and its associated factors among cancer patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Front Oncol 2023; 13:1150303. [PMID: 37124535 PMCID: PMC10130526 DOI: 10.3389/fonc.2023.1150303] [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] [Received: 02/07/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Obesity, especially the hidden type of obesity (central obesity), has been believed to be the major risk factor for developing and progressing non-communicable diseases, including cancers. However, there are limited studies regarding the issue in Ethiopia and the study area. Therefore, this study aimed to evaluate the magnitude of central obesity and its associated factors among cancer patients visited the oncology unit of the University of Gondar Comprehensive Specialized Hospital. Methods An institutional-based cross-sectional study was conducted from January 10 to March 10, 2021. A total of 384 study participants were enrolled using a systematic sampling technique. The data were collected using a semi-structured interviewer-administered questionnaire and were pretested to address the quality of assurance. The weight of the participants was assessed using body mass index (BMI) and central obesity. Both bivariate and multivariate logistic regressions were conducted to identify the factors associated with central obesity, and p-values less than 0.05 with multivariate were considered statistically significant associations. Result Most respondents (60.16%) were stage I cancer patients. The study found that about 19.27% of the participants were prevalent central obesity, and none of them were obese by body mass index (BMI) categorization criteria. However, about 12.24% and 7.03% of the participants were found to be underweight and overweight, respectively. The variables associated with central obesity were sex (AOR=14.40; 95% CI: 5.26 - 39.50), occupation (AOR=4.32; 95%CI: 1.10 - 17.01), and residency (AOR=0.30; 95% CI: 0.13 - 0.70). Conclusion A significant number of the respondents (19.27%) were centrally obese. Being female, urban residency and having an occupation other than a farmer, merchant, and governmental were the factors associated with central obesity. Hence, cancer patients may be centrally obese with average body weight.
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Affiliation(s)
- Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Meseret Derbew Molla,
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ephrem Tafesse Teferi
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Borges PCC, Spencer HB, Barbosa C, Costa V, Furtado A, Leal MC, Lopes C, Ferreira D, Carvalho AL, Dos-Santos-Silva I, Santos LL. XPERT ® breast cancer STRAT4 as an alternative method of identifying breast cancer phenotype in Cape Verde (preliminary results). Ecancermedicalscience 2023; 17:1530. [PMID: 37138965 PMCID: PMC10151082 DOI: 10.3332/ecancer.2023.1530] [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: 11/06/2022] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer (BC) is a public health problem in developing countries, including Cape Verde. Immunohistochemistry (IHC) is the gold standard technique used for BC phenotypic characterisation to support efficient therapeutic decisions. However, IHC is a demanding technique that requires knowledge, trained technicians, expensive antibodies and reagents, controls, and results validation. The low number of cases in Cape Verde increases the risk of expiring the validity of the antibodies, and manual procedures often jeopardise the quality of the results. Thus, IHC is limited in Cape Verde, and an alternative technically easy solution is needed. A point-of-care messenger RNA (mRNA) STRAT4 BC assay to assess estrogen (ER), progesterone (PR), hormone growth factor 2 receptor (HER2), and Ki67, using the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC results.To assess whether this technology can be implemented in Cape Verde to guide BC treatment we decided to study the level of agreement between the findings yielded by BC STRAT4 and the results are the same cases obtained by IHC. Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from 29 Cabo Verdean BC patients diagnosed in Agostinho Neto University Hospital were analysed by applying IHC and BC STRAT4 assay. The time between sample collection and pre-analytic procedures is unknown. All the samples were pre-processed in Cabo Verde (fixed in formalin and embedded in paraffin). IHC studies were performed in referenced laboratories in Portugal. STRAT4 and IHC result concordance was assessed by calculating the percentage of results agreement and Cohen's Kappa (K) statistics. Results STRAT4 assay failed in 2 out of the 29 analysed samples. Of the 27 successfully analysed samples, STRAT4/IHC results for ER, PR, HER2, and Ki67 were concordant in 25, 24, 25, and 18 cases, respectively. Ki67 was indeterminate in three cases, and PR was indeterminate once.The percentage of agreement between STRAT4 and IHC results for ER, PR, HER2, and Ki67 was 92.59%, 92.31%, 92.59% and 81.82%, respectively. The Cohen's K statistic coefficients for each biomarker were 0.809, 0.845, 0.757 and 0.506, respectively. Conclusions According to our preliminary results, a point-of-care mRNA STRAT4 BC assay may be an alternative in laboratories unable to provide quality and/or cost-efficient IHC services. However, more data and improvement on sample pre-analytic processes are required to implement this BC STRAT4 Assay in Cape Verde.
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Affiliation(s)
- Pamela C C Borges
- Laboratório Biologia Molecular, Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | | | - Carla Barbosa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Victor Costa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Antónia Furtado
- IMP Diagnostics, Molecular and Anatomic Pathology Lab, 4150-146, Porto, Portugal
| | - Maria Conceição Leal
- Anatomia Patológica, Instituto Português de Oncologia, 4200-072, Porto, Portugal
| | - Carlos Lopes
- Unilabs | Laboratório Anatomia Patológica, 4250-170, Porto, Portugal
| | - Dylan Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
| | | | | | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
- Surgical Oncology Department, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
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Duffy C, Santana V, Inaba H, Jeha S, Pauley J, Sniderman L, Ghara N, Mushtaq N, Narula G, Bhakta N, Rodriguez-Galindo C, Brandt H. Evaluating blinatumomab implementation in low- and middle-income countries: a study protocol. Implement Sci Commun 2022; 3:62. [PMID: 35690878 PMCID: PMC9187890 DOI: 10.1186/s43058-022-00310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/18/2022] [Indexed: 11/12/2022] Open
Abstract
Background The recent implementation of novel therapies has accelerated progress in pediatric cancer care. Despite the significantly poorer survival of patients in low- and middle-income countries (LMICs), administation complexities and other significant resource barriers have limited the translation of these novel therapies in these regions. This study aims to develop a model that can be used to support the implementation of novel therapies, such as blinatumomab (bispecific antibody therapy for B-cell acute lymphoblastic leukemia [B-ALL]) in LMIC centers, with the long-term goal of developing an implementation framework for similar future efforts. Methods In this study, mixed methods will be applied to understand the key contextual considerations that can be accounted for through a training program and prospectively designed implementation activities. The Consolidated Framework for Implementation Research will guide the activities related to implementation evaluation in parallel with a drug donation program. A multidisciplinary research team comprising high- and low-middle income healthcare professionals, industry, and implementation scientists has been assembled with the common goal of improving safe access to blinatumomab. To assess the factors affecting blinatumomab administration, semi-structured interviews with diverse collaborators and quantitative assessments of organizational characteristics will be conducted, together with quantitative and qualitative assessments of feasibility, acceptability, appropriateness, and cost of blinatumomab implementation. A quantitative assessment of stakeholder perceptions of different implementation strategies used as part of the multifaceted approach will also be performed. Finally, we will examine the key domains and processes used and construct the implementation roadmap for translation of novel therapies. Discussion This study will rigorously develop an implementation roadmap for translation of novel therapies in low-resource settings. The knowledge gained in the formative assessment will reveal the priority areas and key implementation strategies. Thereby, the resultant roadmap will facilitate future scale-out strategies for novel therapies in LMICs, thus increasing access, building capacity for management, and ultimately improving the care for children in LMICs.
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da Silva RGD, Araujo CAS. Initiatives to reduce the waiting time to initiate oncological treatment: a scoping literature review. Rev Panam Salud Publica 2022; 46:e170. [PMID: 36382252 PMCID: PMC9642818 DOI: 10.26633/rpsp.2022.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/06/2022] [Indexed: 11/09/2022] Open
Abstract
Objective. To identify the managerial actions proposed and employed to reduce the waiting time to initiate oncological treatments in the public health system and its application in Latin America. Method. We searched seven databases in December 2020. Search terms were conceptualized into three groups: waiting time, cancer, and terms related to public sector. The eligibility criteria included theoretical or empirical academic articles written in English, Spanish, or Portuguese, that focused on managerial solutions to face oncological healthcare queues' dilemma. Results. The search returned 1 255 articles, and 20 were selected and analysed in this review. Results show that most of the proposals are related to the process and people dimensions. The actions related to the process dimension were mainly associated with programming new treatment pathways and integrating cancer systems. People's dimension initiatives referred mostly to task forces and groups of specialists. Some initiatives were related to implementing technological solutions and the technology dimension, mainly concerning radiotherapy devices' acquisition. Conclusion. Few studies focus on analysing actions to minimize waiting time to initiate oncological treatments. The prevalence of conceptual and illustrative case studies indicates the lack of research maturity on this theme. Future studies should focus on setting the field's theoretical foundations, considering the existing paradigms, or developing new ones. There is a need for empirical studies applying a multidisciplinary approach to face the oncological treatment waiting time challenge and proposing new and innovative initiatives.
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Sakafu LL, Philipo GS, Malichewe CV, Fundikira LS, Lwakatare FA, Van Loon K, Mushi BP, DeBoer RJ, Bialous SA, Lee AY. Delayed diagnostic evaluation of symptomatic breast cancer in sub-Saharan Africa: A qualitative study of Tanzanian women. PLoS One 2022; 17:e0275639. [PMID: 36201503 PMCID: PMC9536581 DOI: 10.1371/journal.pone.0275639] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Women with breast cancer in sub-Saharan Africa are commonly diagnosed at advanced stages. In Tanzania, more than 80% of women are diagnosed with stage III or IV disease, and mortality rates are high. This study explored factors contributing to delayed diagnostic evaluation among women with breast cancer in Tanzania. Methods A qualitative study was performed at Muhimbili National Hospital in Dar es Salaam, Tanzania. Twelve women with symptomatic pathologically proven breast cancer were recruited. In-depth, semi-structured interviews were conducted in Swahili. Interviews explored the women’s journey from symptom recognition to diagnosis, including the influence of breast cancer knowledge and pre-conceptions, health seeking behaviors, psychosocial factors, preference for alternative treatments, and the contribution of culture and norms. Audio-recorded interviews were transcribed and translated into English. Thematic analysis was facilitated by a cloud-based qualitative analysis software. Results All women reported that their first breast symptom was a self-identified lump or swelling. Major themes for factors contributing to delayed diagnostic presentation of breast cancer included lack of basic knowledge and awareness of breast cancer and misconceptions about the disease. Participants faced barriers with their local primary healthcare providers, including symptom mismanagement and delayed referrals for diagnostic evaluation. Other barriers included financial hardships, fear and stigma of cancer, and use of traditional medicine. The advice and influence of family members and friends played key roles in healthcare-seeking behaviors, serving as both facilitators and barriers. Conclusion Lack of basic knowledge and awareness of breast cancer, stigma, financial barriers, and local healthcare system barriers were common factors contributing to delayed diagnostic presentation of breast cancer. The influence of friends and family also played key roles as both facilitators and barriers. This information will inform the development of educational intervention strategies to address these barriers and improve earlier diagnosis of symptomatic breast cancer in Tanzania.
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Affiliation(s)
- Lulu Lunogelo Sakafu
- Department of Radiology, Muhimbili National Hospital, Dar es Salaam, Tanzania
- * E-mail: (LLS); (AYL)
| | | | | | - Lulu S. Fundikira
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Flora A. Lwakatare
- Department of Radiology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Katherine Van Loon
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco (UCSF), San Francisco, California, United States of America
| | - Beatrice P. Mushi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Rebecca J. DeBoer
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco (UCSF), San Francisco, California, United States of America
| | - Stella A. Bialous
- Department of Social and Behavioral Sciences, University of California San Francisco (UCSF), San Francisco, California, United States of America
| | - Amie Y. Lee
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, California, United States of America
- * E-mail: (LLS); (AYL)
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Gitonga I, Desmond D, Duda N, Maguire R. Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta-analysis. Psychooncology 2022; 31:1621-1636. [PMID: 35996330 PMCID: PMC9825891 DOI: 10.1002/pon.6019] [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: 04/22/2022] [Revised: 08/07/2022] [Accepted: 08/15/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Connected health technologies have the potential to improve access to cancer care and support and reduce costs. We aimed to assess the impacts of interventions delivered using connected health technologies on psychological and quality of life (QoL) outcomes in people living with and beyond cancer. METHODS PUBMED, PsycINFO, Web of Science, and EMBASE were searched using terms relating to (i) cancer, (ii) connected health, and (iii) QoL/psychological wellbeing. Studies were included if they evaluated interventions using connected health technologies and assessed psychological and/or QoL outcomes for adults at any stage of cancer treatment or survivorship. RESULTS Thirty-seven studies met the inclusion criteria with a total of 8956 participants. Connected health technologies included web-based applications (n = 24), smart applications (n = 12), and wearable devices (n = 1). Studies were heterogeneous in terms of intervention components. We identified five clusters: (i) Psychosocial support and rehabilitation, (ii) psychoeducation and information support, (iii) symptom monitoring, reporting and self-management, (iv) peer and social support, and (v) health coaching and physical activity training. Due to heterogeneity of outcome measures, the meta-analysis included only seven RCTs; pooled mean estimates showed connected health interventions were moderately effective in reducing symptoms of depression (SMD: -0.226, 95% CI -0.303/-0.149) and anxiety (SMD: -0.188, 95% CI: 0.279/-0.0963) compared with usual care. CONCLUSION While the considerable heterogeneity observed highlights the need for more rigorous studies to improve reproducibility and efficiency, results suggest that connected health interventions have the potential to improve psychological wellbeing and QoL outcomes in people living with and beyond cancer.
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Affiliation(s)
- Isaiah Gitonga
- Department of PsychologyMaynooth UniversityMaynoothIreland
- Assisting Living and Learning InstituteMaynooth UniversityMaynoothIreland
| | - Deirdre Desmond
- Department of PsychologyMaynooth UniversityMaynoothIreland
- Assisting Living and Learning InstituteMaynooth UniversityMaynoothIreland
| | - Natalia Duda
- School of PsychologyTrinity College DublinDublinIreland
| | - Rebecca Maguire
- Department of PsychologyMaynooth UniversityMaynoothIreland
- Assisting Living and Learning InstituteMaynooth UniversityMaynoothIreland
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Cancer burden and status of cancer control measures in fragile states: a comparative analysis of 31 countries. Lancet Glob Health 2022; 10:e1443-e1452. [DOI: 10.1016/s2214-109x(22)00331-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/20/2022] [Accepted: 07/20/2022] [Indexed: 12/25/2022]
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Fatoki RA, Koehn K, Kelkar A, Al Hadidi S, Mehra N, Mian H, Landgren O, Kazandjian D, Hoffman J, Sborov DW, Mohyuddin GR. Global Myeloma Trial Participation and Drug Access in the Era of Novel Therapies. JCO Glob Oncol 2022; 8:e2200119. [PMID: 35960904 PMCID: PMC9470137 DOI: 10.1200/go.22.00119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/23/2022] [Accepted: 06/29/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The globalization of clinical trials has accelerated recent advances in multiple myeloma (MM). However, it is unclear whether trial enrollment locations are reflective of the global burden of MM and whether access to novel therapies is timely and equitable for countries that participate in those trials. METHODS To assess this, we characterized where MM trials that led to US Food and Drug Administration (FDA) approvals were conducted and determined how often and quickly these drug regimens received approval in their participating trial countries on the basis of country income level and geographic region. RESULTS A systematic review was conducted to identify all MM clinical trials that met their primary endpoint, enrolled patients outside the United States, and resulted in FDA approval from 2005 to 2019. A total of 18 pivotal MM clinical trials were identified. High-income countries enrolled patients in 100% (18/18) of the trials identified, whereas upper-middle and lower-middle-income countries were represented in 61% (11/18) and 28% (5/18) of trials, respectively. No patients from low-income countries were enrolled. One trial enrolled patients in sub-Saharan Africa, and no trials enrolled patients in South Asia/Caribbean. For drugs/regimens that were approved in their participating countries, the median time from FDA approval to approval was 10.9 months. There were no drugs approved in lower-middle-income trial countries. MM trials leading to FDA approval are generally run in high-income, European, and Central Asian countries. CONCLUSION There are substantial disparities in where novel therapies are evaluated and where they are ultimately approved for use on the basis of income level and geography.
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Affiliation(s)
- Raleigh Ayoolu Fatoki
- Internal Medicine Department, Kaiser Permanente – Oakland Medical Center, Oakland, CA
| | - Kelly Koehn
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas, Kansas City, KS
| | - Amar Kelkar
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Samer Al Hadidi
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Nikita Mehra
- Department of Medical Oncology and Molecular Oncology, Cancer Institute (WIA), Chennai, India
| | - Hira Mian
- Department of Oncology, Juravinski Hospital and Cancer Centre-Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ola Landgren
- Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Dickran Kazandjian
- Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - James Hoffman
- Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Douglas W. Sborov
- Division of Hematology and Hematological Malignancies, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | - Ghulam Rehman Mohyuddin
- Division of Hematology and Hematological Malignancies, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
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Targeting Tumor Acidosis and Regulatory T Cells Unmasks Anti-Metastatic Potential of Local Tumor Ablation in Triple-Negative Breast Cancer. Int J Mol Sci 2022; 23:ijms23158479. [PMID: 35955613 PMCID: PMC9368760 DOI: 10.3390/ijms23158479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 01/27/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is an immunologically heterogenous disease that lacks clinically actionable targets and is more likely to progress to metastatic disease than other types of breast cancer. Tumor ablation has been used to increase response rates to checkpoint inhibitors, which remain low for TNBC patients. We hypothesized that tumor ablation could produce an anti-tumor response without using checkpoint inhibitors if immunosuppression (i.e., Tregs, tumor acidosis) was subdued. Tumors were primed with sodium bicarbonate (200 mM p.o.) to reduce tumor acidosis and low-dose cyclophosphamide (100–200 mg/kg i.p.) to deplete regulatory T cells, as has been shown independently in previous studies. A novel injectable ablative was then used to necrose the tumor, release tumor antigens, and initiate an immune event that could create an abscopal effect. This combination of bicarbonate, cyclophosphamide, and ablation, called “BiCyclA”, was tested in three syngeneic models of TNBC: E0771 (C57BL/6), 67NR (BALB/c), and 4T1-Luc (BALB/c). In E0771 and 67NR, BiCyclA therapy significantly reduced tumor growth and cured 5/7 and 6/10 mice 50 days after treatment respectively. In the metastatic 4T1-Luc tumors, for which surgery and checkpoint inhibitors fail, BiCyclA cured 5/10 mice of primary tumors and lung metastases. Notably, CD4+ and CD8+ T cells were found to be crucial for the anti-metastatic response, and cured mice were able to resist tumor rechallenge, suggesting production of immune memory. Reduction of tumor acidity and regulatory T cells with ablation is a simple yet effective therapy for local and systemic tumor control with broad applicability as it is not limited by expensive supplies.
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LeBaron VT, Horton BJ, Adhikari A, Chapagain S, Dhakal M, Gongal R, Kattel R, Koirala G, Kutcher A, Hass B, Maurer M, Munday D, Neupane B, Sharma K, Shilpakar R, Shrestha A, Shrestha S, Thapa U, Dillingham R, Paudel BD. A Global Collaboration to Develop and Pilot Test a Mobile Application to Improve Cancer Pain Management in Nepal. FRONTIERS IN PAIN RESEARCH 2022; 3:910995. [PMID: 35965597 PMCID: PMC9366104 DOI: 10.3389/fpain.2022.910995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionQuality palliative care, which prioritizes comfort and symptom control, can reduce global suffering from non-communicable diseases, such as cancer. To address this need, the Nepalese Association of Palliative Care (NAPCare) created pain management guidelines (PMG) to support healthcare providers in assessing and treating serious pain. The NAPCare PMG are grounded in World Health Organization best practices but adapted for the cultural and resource context of Nepal. Wider adoption of the NAPCare PMG has been limited due to distribution of the guidelines as paper booklets.MethodsBuilding on a long-standing partnership between clinicians and researchers in the US and Nepal, the NAPCare PMG mobile application (“app”) was collaboratively designed. Healthcare providers in Nepal were recruited to pilot test the app using patient case studies. Then, participants completed a Qualtrics survey to evaluate the app which included the System Usability Scale (SUS) and selected items from the Mobile App Rating Scale (MARS). Descriptive and summary statistics were calculated and compared across institutions and roles. Regression analyses to explore relationships (α = 0.05) between selected demographic variables and SUS and MARS scores were also conducted.ResultsNinety eight healthcare providers (n = 98) pilot tested the NAPCare PMG app. Overall, across institutions and roles, the app received an SUS score of 76.0 (a score > 68 is considered above average) and a MARS score of 4.10 (on a scale of 1 = poor, 5 = excellent). 89.8% (n = 88) “agreed” or “strongly agreed” that the app will help them better manage cancer pain. Age, years of experience, and training in palliative care were significant in predicting SUS scores (p-values, 0.0124, 0.0371, and 0.0189, respectively); institution was significant in predicting MARS scores (p = 0.0030).ConclusionThe NAPCare PMG mobile app was well-received, and participants rated it highly on both the SUS and MARS. Regression analyses suggest end-user variables important to consider in designing and evaluating mobile apps in lower resourced settings. Our app design and pilot testing process illustrate the benefits of cross global collaborations to build research capacity and generate knowledge within the local context.
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Affiliation(s)
- Virginia T. LeBaron
- University of Virginia School of Nursing, Charlottesville, VA, United States
- *Correspondence: Virginia T. LeBaron
| | - Bethany J. Horton
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Sandhya Chapagain
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Manita Dhakal
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | | | - Regina Kattel
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | | | - Anna Kutcher
- University of Virginia School of Nursing, Charlottesville, VA, United States
| | - Ben Hass
- Hass Software Consulting, Brooklyn, NY, United States
| | - Martha Maurer
- Sonderegger Research Center, University of Wisconsin School of Pharmacy, Madison, WI, United States
| | - Daniel Munday
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Bijay Neupane
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | | | - Ramila Shilpakar
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Amuna Shrestha
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Sudip Shrestha
- Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Usha Thapa
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Rebecca Dillingham
- University of Virginia School of Medicine, Charlottesville, VA, United States
- University of Virginia Center for Global Health Equity, Charlottesville, VA, United States
| | - Bishnu D. Paudel
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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Allahqoli L, Mazidimoradi A, Momenimovahed Z, Rahmani A, Hakimi S, Tiznobaik A, Gharacheh M, Salehiniya H, Babaey F, Alkatout I. The Global Incidence, Mortality, and Burden of Breast Cancer in 2019: Correlation With Smoking, Drinking, and Drug Use. Front Oncol 2022; 12:921015. [PMID: 35965518 PMCID: PMC9363894 DOI: 10.3389/fonc.2022.921015] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Female breast cancer (FBC) is the most common type of cancer and is associated with a considerable disease burden as well as significant mortality rates. The present study aimed to provide an update on the incidence, mortality, and burden of FBC in 2019, based on the Global Burden of Disease (GBD) Study. Materials The incidence, death rate, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), the age-standardized rates (ASR) of FBC in 204 countries, and a variety of classifications, were retrieved from the Global Burden of Disease Study. Data on tobacco use, alcohol consumption, and drug use were collected. The incidence, mortality, and burden of FBC were registered and compared between regions. Associations between age-standardized incidence rates and age-standardized mortality rates of FBC with smoking, drinking, and drug use were determined. Results The highest incidence of FBC was observed in countries with a high socioeconomic status such as those of the European continent. Despite the lower incidence of FBC in countries with a low socio-demographic index (SDI), mortality rates secondary to FBC are higher in these countries than in high-income countries. The highest age-standardized mortality rate has been reported in the Eastern Mediterranean Region (EMRO), followed by the African Region (AFRO). The highest age-standardized rates of DALY and YLL per 100,000 population in 2019 were observed in lower-income countries, while the highest ASR of YLD per 100,000 population was reported in high-income countries. Conclusion The present GBD-based study provides a comprehensive review of the incidence, mortality, and burden of FBC in 2019. The incidence of FBC is higher in regions with a higher socioeconomic status, whereas mortality rates and DALYs are higher in poorly developed regions. We suggest better screening measures and early detection programs for the latter regions.
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Affiliation(s)
- Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | - Afrooz Mazidimoradi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohre Momenimovahed
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sevil Hakimi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azita Tiznobaik
- Department of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Gharacheh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farah Babaey
- Head of Midwifery Department at Ministry of Health and Medical Education, Tehran, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Kiel School of Gynaecological Endoscopy, Kiel, Germany
- *Correspondence: Ibrahim Alkatout,
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46
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Transfer learning for histopathology images: an empirical study. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07516-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Germans N, Ellis P, Wilson S, Merriman A, Rabwoni M. The socioeconomic burden of a diagnosis of cervical cancer in women in rural Uganda: findings from a descriptive qualitative study. Int J Palliat Nurs 2022; 28:322-332. [PMID: 35861442 DOI: 10.12968/ijpn.2022.28.7.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The aim of the study was to diagnose the socioeconomic burden and impact of a diagnosis of cervical cancer in rural women in the context of a low-resourced country, Uganda, through a descriptive qualitative enquiry. METHODS This was a multi-site descriptive qualitative inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in the Southwest, Little Hospice Hoima in Midwest, and Hospice Africa Uganda Kampala in Central Uganda. A purposive sample of women with a histologically confirmed diagnosis of cervical cancer were recruited. Data were collected using open-ended audio-recorded interviews conducted in the native languages of the participants. Interviews were transcribed verbatim in English. Braun and Clarke's (2019) framework of thematic analysis was used. RESULTS A total of 13 women, with mean age 49.2 years (range 29-71), participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A detailed reading of transcripts produced three major themes: (1) the impact of cervical cancer on women's relationships (2) the disrupted and impaired activities of daily living (ADLs), and (3) economic disruptions. CONCLUSIONS A diagnosis of cervical cancer introduces significant socioeconomic disruptions in a woman's and her family's life. Cervical cancer causes disability, impairs the woman and her family's productivity and exacerbates levels of poverty in the home. High and expensive out-of-pocket expenditure on investigations, treatments and transport costs further compound the socioeconomic burden.
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Affiliation(s)
- Natuhwera Germans
- Palliative Care Clinician and Site Programs Manager, Little Hospice Hoima, Hospice Africa, Uganda
| | - Peter Ellis
- Independent Nursing Writer, Educator and CEO Intelligent Care Software; Honorary Senior Research Fellow, Canterbury Christ Church University, UK
| | - Stanley Wilson
- Professor, Consultant Psychiatrist and Lecturer, Institute of Hospice and Palliative Care in Africa, Hospice Africa, Uganda
| | - Anne Merriman
- Professor, Consultant Palliative Care Advocate and Physician, Founder Hospice Africa; Director of Policy, Hospice Africa, Uganda
| | - Martha Rabwoni
- Senior Palliative Care Nurse; Health Services Coordinator Mobile Hospice Mbarara, Hospice Africa, Uganda
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Molebatsi K, Iyer HS, Kohler RE, Gabegwe K, Nkele I, Rabasha B, Botebele K, Barak T, Balosang S, Tapela NM, Dryden-Peterson SL. Improving identification of symptomatic cancer at primary care clinics: A predictive modeling analysis in Botswana. Int J Cancer 2022; 151:1663-1673. [PMID: 35716138 PMCID: PMC10286759 DOI: 10.1002/ijc.34178] [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: 11/16/2021] [Revised: 02/26/2022] [Accepted: 03/08/2022] [Indexed: 12/24/2022]
Abstract
In resource-limited settings, augmenting primary care provider (PCP)-based referrals with data-derived algorithms could direct scarce resources towards those patients most likely to have a cancer diagnosis and benefit from early treatment. Using data from Botswana, we compared accuracy of predictions of probable cancer using different approaches for identifying symptomatic cancer at primary clinics. We followed cancer suspects until they entered specialized care for cancer treatment (following pathologically confirmed diagnosis), exited from the study following noncancer diagnosis, or died. Routine symptom and demographic data included baseline cancer probability assessed by the primary care provider (low, intermediate, high), age, sex, performance status, baseline cancer probability by study physician, predominant symptom (lump, bleeding, pain or other) and HIV status. Logistic regression with 10-fold cross-validation was used to evaluate classification by different sets of predictors: (1) PCPs, (2) Algorithm-only, (3) External specialist physician review and (4) Primary clinician augmented by algorithm. Classification accuracy was assessed using c-statistics, sensitivity and specificity. Six hundred and twenty-three adult cancer suspects with complete data were retained, of whom 166 (27%) were diagnosed with cancer. Models using PCP augmented by algorithm (c-statistic: 77.2%, 95% CI: 73.4%, 81.0%) and external study physician assessment (77.6%, 95% CI: 73.6%, 81.7%) performed better than algorithm-only (74.9%, 95% CI: 71.0%, 78.9%) and PCP initial assessment (62.8%, 95% CI: 57.9%, 67.7%) in correctly classifying suspected cancer patients. Sensitivity and specificity statistics from models combining PCP classifications and routine data were comparable to physicians, suggesting that incorporating data-driven algorithms into referral systems could improve efficiency.
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Affiliation(s)
- Kesaobaka Molebatsi
- Department of Statistics, University of Botswana, Gaborone, Botswana.,Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Hari S Iyer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Racquel E Kohler
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kemiso Gabegwe
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Isaac Nkele
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Bokang Rabasha
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - Tomer Barak
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Neo M Tapela
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Nuffield Department of Population Health, Oxford University, Oxford, UK
| | - Scott L Dryden-Peterson
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Jalali R, Nogueira-Rodrigues A, Das A, Sirohi B, Panda PK. Drug Development in Low- and Middle-Income Countries: Opportunity or Exploitation? Am Soc Clin Oncol Educ Book 2022; 42:1-8. [PMID: 35658520 DOI: 10.1200/edbk_10033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low- and middle-income countries (LMICs) represent a diverse group of regions with varied cancer presentation. Drug development and accessibility across these regions have primarily been dependent on the trials initiated and conducted across high-income countries. Representation of LMIC regions in these trials in terms of study population has been minimal, leading to inequitable distribution of optimal and affordable cancer care. In spite of many challenges, LMICs have now increasingly been able to contribute to anticancer drug development. The opportunities present in LMICs must be explored and used in conjunction with due collaborative efforts from high-income countries, health care planners, and regulatory agencies. Global drug development trials should not only factor in suitable representation of LMICs but also design studies with pragmatic objectives and endpoints so that the trial results lead to equitable and affordable cancer care. Strengthening collaboration between cancer researchers from LMICs and high-income countries and empowering the local investigator with adequate resources will help remove current disparities.
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Affiliation(s)
- Rakesh Jalali
- Neuro-Oncology Cancer Management Team, Apollo Proton Cancer Centre, Taramani, Chennai, India
| | - Angelica Nogueira-Rodrigues
- Federal University of Minas Gerais, DOM Oncologia, Grupo Oncoclínicas, EVA Brazilian Group of Gynecologic Cancer, LACOG, Porto Alegre, Brazil
| | - Arunangshu Das
- Department of Oncology, Square Hospitals Ltd, Dhaka, Bangladesh
| | - Bhawna Sirohi
- Department of Medical Oncology, Apollo Proton Cancer Centre, Taramani, Chennai, India
| | - Pankaj Kumar Panda
- Clinical Research Secretariat, Apollo Proton Cancer Centre, Taramani, Chennai, India
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Buckley L, Bacha B, Gaudet M, Haché C, Lacelle M, Naoun L, Wooster E, Bourque JM. Development of a Curriculum for the Implementation of Stereotactic Radiation Therapy Programs in Middle-Income Countries. JCO Glob Oncol 2022; 8:e2100389. [PMID: 35749677 PMCID: PMC9259141 DOI: 10.1200/go.21.00389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this work was to develop a curriculum to be used in the implementation of stereotactic radiation therapy programs in middle-income countries. The curriculum needed to be scalable and flexible to be easily adapted to local situations. METHODS The curriculum was developed through a partnership between multidisciplinary teams from established clinics in both middle-income and high-income countries. The curriculum development followed a nonlinear progression, allowing greater flexibility throughout the process. A blended learning model was used, combining virtual and in-person interactions. RESULTS The initial training plan was based on a needs assessment provided by the learners and on the experience of the facilitators with stereotactic radiotherapy. The needs assessment was refined during in-person site visits at each institution which highlighted aspects of the training, such as image guidance workflows and technical specifications, that were not previously emphasized in the curriculum. Both teams found that the in-person visits were important for training purposes, but aspects of the curriculum delivery such as treatment planning and patient selection were well suited to virtual platforms. The training addressed all aspects of the stereotactic program, from patient selection to treatment, and included a review of both technical and clinical workflows. CONCLUSION The inclusion of contributions from both teams ensured that the curriculum covered the required elements of the stereotactic program implementation, met the needs of the learners, and was relevant to local practices. The nonlinear approach to the curriculum development allowed the flexibility to change the focus as the project progressed. The in-person visits were valuable in conducting a thorough needs assessment.
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Affiliation(s)
- Lesley Buckley
- Radiation Medicine Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Billel Bacha
- Service de radiothérapie, Centre de Lutte Contre le Cancer, Annaba, Algeria
| | - Marc Gaudet
- Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada
| | - Christiane Haché
- Radiation Medicine Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Manon Lacelle
- Radiation Medicine Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Lilia Naoun
- Service de radiothérapie, Centre de Lutte Contre le Cancer, Annaba, Algeria
| | - Elizabeth Wooster
- Ontario Institute of Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Jean-Marc Bourque
- Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada
- Radiation Oncology, Montreal University Health Centre, Montreal, QC, Canada
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