1
|
Nelson D, Selby P, Kane R, Harding-Bell A, Kenny A, McPeake K, Cooke S, Hogue T, Oliver K, Gussy M, Lawler M. Implementing the European code of cancer practice in rural settings. J Cancer Policy 2024; 39:100465. [PMID: 38184144 DOI: 10.1016/j.jcpo.2023.100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
Existing evidence often indicates higher cancer incidence and mortality rates, later diagnosis, lower screening uptake and poorer long-term survival for people living in rural compared to more urbanised areas. Despite wide inequities and variation in cancer care and outcomes across Europe, much of the scientific literature explicitly exploring the impact of rurality on cancer continues to come from Australia and North America. The European Code of Cancer Practice or "The Code" is a citizen and patient-centred statement of the most salient requirements for good clinical cancer practice and has been extensively co-produced by cancer patients, cancer professionals and patient advocates. It contains 10 key overarching Rights that a cancer patient should expect from their healthcare system, regardless of where they live and has been strongly endorsed by professional and patient cancer organisations as well as the European Commission. In this article, we use these 10 fundamental Rights as a framework to argue that (i) the issues and needs identified in The Code are generally more profound for rural people with cancer; (ii) addressing these issues is also more challenging in rural contexts; (iii) interventions and support must explicitly account for the unique needs of rural residents living with and affected by cancer and (iv) new innovative approaches are urgently required to successfully overcome the challenges faced by rural people with cancer and their caregivers. Despite equitable healthcare being a key European policy focus, the needs of rural people living with cancer have largely been neglected.
Collapse
Affiliation(s)
- David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; Macmillan Cancer Support, London, UK.
| | - Peter Selby
- Faculty of Medicine and Health, University of Leeds, Leeds, UK; Lincoln Medical School, Universities of Nottingham and Lincoln, Lincoln, UK
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | | | - Amanda Kenny
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Kathie McPeake
- Macmillan Cancer Support, London, UK; NHS Lincolnshire Integrated Care Board, Sleaford, UK
| | - Samuel Cooke
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Todd Hogue
- School of Psychology, University of Lincoln, Lincoln, UK
| | | | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queens University Belfast, Belfast, UK
| |
Collapse
|
2
|
Buyens G, van Balken M, Oliver K, Price R, Venegoni E, Lawler M, Battisti NML, Van Poppel H. Cancer literacy - Informing patients and implementing shared decision making. J Cancer Policy 2023; 35:100375. [PMID: 36462750 DOI: 10.1016/j.jcpo.2022.100375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
In order to tailor treatment to their needs, cancer patients are encouraged to be more active and engaged in their care decisions and to be autonomous yet collaborative with their healthcare professionals when it comes to aspects of their treatment in order to get better results. However, this can only happen after providing them with accurate information about cancer and the different treatment alternatives and their potential side effects. However, sharing robust data-based information is often hindered by exposure to misleading information through different media and online platform, where patients might come across unscientifically founded health practices. Increasing health literacy and cancer-specific literacy is essential to fight this negative trend. The idea is that more knowledgeable patients will be able to debunk more easily misinformation they encounter. This is also related to inequalities among cancer patients. Not only levels of cancer literacy within Europe are uneven across and within countries, but there are social groups that, due to specific social determinants, are systematically less informed and skilled regarding cancer care. In this paper an overview of gaps in addressing literacy issues, and the importance of health literacy to empower patients in their journey through treatment is delineated, concluding with some recommendations to improve cancer literacy in Europe.
Collapse
Affiliation(s)
| | - Michael van Balken
- European Association of Urology Patient Office (EAU-PO), NL; Rijnstate Hospital, Arnhem, NL
| | | | | | | | - Mark Lawler
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK
| | | | | |
Collapse
|
3
|
Lawler M, Davies L, Oberst S, Oliver K, Eggermont A, Schmutz A, La Vecchia C, Allemani C, Lievens Y, Naredi P, Cufer T, Aggarwal A, Aapro M, Apostolidis K, Baird AM, Cardoso F, Charalambous A, Coleman MP, Costa A, Crul M, Dégi CL, Di Nicolantonio F, Erdem S, Geanta M, Geissler J, Jassem J, Jagielska B, Jonsson B, Kelly D, Kelm O, Kolarova T, Kutluk T, Lewison G, Meunier F, Pelouchova J, Philip T, Price R, Rau B, Rubio IT, Selby P, Južnič Sotlar M, Spurrier-Bernard G, van Hoeve JC, Vrdoljak E, Westerhuis W, Wojciechowska U, Sullivan R. European Groundshot-addressing Europe's cancer research challenges: a Lancet Oncology Commission. Lancet Oncol 2023; 24:e11-e56. [PMID: 36400101 DOI: 10.1016/s1470-2045(22)00540-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035.
Collapse
Affiliation(s)
- Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK.
| | - Lynne Davies
- International Cancer Research Partnership, International House, Cardiff, UK
| | - Simon Oberst
- Organisation of European Cancer Institutes, Brussels, Belgium
| | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, UK; European Cancer Organisation Patient Advisory Committee, Brussels, Belgium
| | - Alexander Eggermont
- Faculty of Medicine, Utrecht University Medical Center, Utrecht, Netherlands; Princess Máxima Centrum, Utrecht, Netherlands
| | - Anna Schmutz
- International Agency for Cancer Research, Lyon, France
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Peter Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tanja Cufer
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK; Institute of Cancer Policy, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matti Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - Kathi Apostolidis
- Hellenic Cancer Federation, Athens, Greece; European Cancer Patient Coalition, Brussels, Belgium
| | - Anne-Marie Baird
- Lung Cancer Europe, Bern, Switzerland; Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Fatima Cardoso
- Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Andreas Charalambous
- European Cancer Organisation Brussels, Brussels, Belgium; Department of Nursing, Cyprus University of Technology, Limassol, Cyprus; Department of Oncology, University of Turku, Turku, Finland
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Csaba L Dégi
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Federica Di Nicolantonio
- Department of Oncology, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee, Europa Donna, Istanbul, Türkiye
| | - Marius Geanta
- Centre for Innovation in Medicine and Kol Medical Media, Bucharest, Romania
| | - Jan Geissler
- Patvocates and CML Advocates Network, Leukaemie-Online (LeukaNET), Munich, Germany
| | | | - Beata Jagielska
- Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Olaf Kelm
- International Agency for Research on Cancer, Lyon, France
| | | | - Tezer Kutluk
- Faculty of Medicine & Cancer Institute, Hacettepe University, Ankara, Türkiye
| | - Grant Lewison
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
| | | | | | - Thierry Philip
- Organisation of European Cancer Institutes, Brussels, Belgium; Institut Curie, Paris, France
| | - Richard Price
- European Cancer Organisation Brussels, Brussels, Belgium
| | - Beate Rau
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Peter Selby
- School of Medicine, University of Leeds, Leeds, UK
| | | | | | - Jolanda C van Hoeve
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Eduard Vrdoljak
- Department of Oncology, University Hospital Center Split, School of Medicine, University of Split, Split, Croatia
| | - Willien Westerhuis
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | | | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
| |
Collapse
|
4
|
Normanno N, Apostolidis K, Wolf A, Al Dieri R, Deans Z, Fairley J, Maas J, Martinez A, Moch H, Nielsen S, Pilz T, Rouleau E, Patton S, Williams V. Access and quality of biomarker testing for precision oncology in Europe. Eur J Cancer 2022; 176:70-77. [PMID: 36194905 DOI: 10.1016/j.ejca.2022.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Predictive biomarkers are essential for selecting the best therapeutic strategy in patients with cancer. The International Quality Network for Pathology, the European Cancer Patient Coalition and the European Federation of Pharmaceuticals Industries and Associations evaluated the access to and quality of biomarker testing across Europe. METHODS Data sources included surveys of 141 laboratory managers and 1.665 patients, and 58 in-depth interviews with laboratory managers, physicians and payers. Four access metrics (laboratory access, test availability, test reimbursement, test order rate) and three quality metrics (quality scheme participation, laboratory accreditation, test turnaround time) were applied to rank the results. RESULTS The access to precision medicines is higher in countries with public national reimbursement processes in place. Lack of diagnostic laboratory infrastructure, inefficient organization and/or insufficient public reimbursement narrow the access to single biomarker tests in many European countries. In countries with limited public reimbursement, pharma and patients' out of pocket were the primary funding sources for testing. Uptake of multi-biomarker next generation sequencing (NGS) is highly varied, ranging from 0% to >50%. Financial constraints, a lack of NGS testing capabilities and the failure to include NGS testing in the guidelines represent the main barriers to NGS implementation. The quality of biomarker testing is highest in Western and Northern Europe, with more than 90% of laboratories participating in quality assurance schemes. CONCLUSIONS Our data clearly indicate the need for a call to action to ensure the clinical implementation of precision medicine in Europe.
Collapse
Affiliation(s)
- Nicola Normanno
- Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy.
| | | | | | - Raed Al Dieri
- European Society of Pathology (ESP), Brussels, Belgium
| | | | | | - Jörg Maas
- Deutsche Gesellschaft für Pathologie E.V. (DGP), Berlin, Germany
| | | | - Holger Moch
- University Hospital and University, Zurich, Switzerland
| | | | | | | | | | | |
Collapse
|
5
|
Vaz-Luis I, Masiero M, Cavaletti G, Cervantes A, Chlebowski RT, Curigliano G, Felip E, Ferreira AR, Ganz PA, Hegarty J, Jeon J, Johansen C, Joly F, Jordan K, Koczwara B, Lagergren P, Lambertini M, Lenihan D, Linardou H, Loprinzi C, Partridge AH, Rauh S, Steindorf K, van der Graaf W, van de Poll-Franse L, Pentheroudakis G, Peters S, Pravettoni G. ESMO Expert Consensus Statements on Cancer Survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 2022; 33:1119-1133. [PMID: 35963481 DOI: 10.1016/j.annonc.2022.07.1941] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increased number of cancer survivors and the recognition of physical and psychosocial challenges, present from cancer diagnosis through active treatment and beyond, led to the discipline of cancer survivorship. DESIGN AND METHODS Herein, we reflected on the different components of survivorship care, existing models and priorities, in order to facilitate the promotion of high-quality European survivorship care and research. RESULTS We identified five main components of survivorship care: (i) physical effects of cancer and chronic medical conditions; (ii) psychological effects of cancer; (iii) social, work and financial effects of cancer; (iv) surveillance for recurrences and second cancers; and (v) cancer prevention and overall health and well-being promotion. Survivorship care can be delivered by structured care models including but not limited to shared models integrating primary care and oncology services. The choice of the care model to be implemented has to be adapted to local realities. High-quality care should be expedited by the generation of: (i) focused and shared European recommendations, (ii) creation of tools to facilitate implementation of coordinated care and (iii) survivorship educational programs for health care teams and patients. The research agenda should be defined with the participation of health care providers, researchers, policy makers, patients and caregivers. The following patient-centered survivorship research areas were highlighted: (i) generation of a big data platform to collect long-term real-world data in survivors and healthy controls to (a) understand the resources, needs and preferences of patients with cancer, and (b) understand biological determinants of survivorship issues, and (ii) develop innovative effective interventions focused on the main components of survivorship care. CONCLUSIONS The European Society for Medical Oncology (ESMO) can actively contribute in the efforts of the oncology community toward (a) promoting the development of high-quality survivorship care programs, (b) providing educational material and (c) aiding groundbreaking research by reflecting on priorities and by supporting research networking.
Collapse
Affiliation(s)
- I Vaz-Luis
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy-Cancer Campus, Villejuif; UMR 981, Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy-Cancer Campus, Villejuif, France.
| | - M Masiero
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| | - G Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - A Cervantes
- Department of Medical Oncology, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - E Felip
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon; Catolica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - P A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, USA
| | - J Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - J Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients (ICONS), Department of Sport Industry, Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - C Johansen
- Centre for Cancer Late Effect Research (CASTLE), Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, U1086 Anticipe, Unicaen Normandy Universtity, Caen, France
| | - K Jordan
- Department for Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - B Koczwara
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - P Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery and Cancer, Imperial College London, London, UK
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Lenihan
- International Cardio-Oncology Society, Tampa, USA
| | - H Linardou
- Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital, Athens, Greece
| | | | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Rauh
- Department of Medical Oncology, Centre Hospitalier Emile Mayrisch, Esch, Luxembourg
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer institute, Erasmus University Medical Center, Rotterdam
| | - L van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, Department of Psycological Research, The Netherlands Cancer Institute, Amsterdam; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| |
Collapse
|
6
|
Silva MJSD, Osorio-de-Castro CGS. Estratégias adotadas para a garantia dos direitos da pessoa com câncer no âmbito Sistema Único de Saúde (SUS). Ciênc saúde coletiva 2022; 27:399-408. [DOI: 10.1590/1413-81232022271.39502020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
Resumo Este estudo, fundamentado na Teoria da Estruturação de Giddens, buscou analisar as estratégias adotadas para garantir os direitos das pessoas com câncer em cinco municípios brasileiros, a partir da experiência de gestores e profissionais de saúde no contexto do Sistema Único de Saúde. Foi conduzido um estudo de casos múltiplos. A unidade de análise foi o município e a subunidade foi a unidade habilitada de atenção oncológica. Foi realizada a análise de conduta estratégica de dez gestores e 15 profissionais de saúde, a partir de entrevistas. Os resultados foram sistematizados em três dimensões: assistencial, judicial e social. Destacaram-se: a necessidade de expansão e organização da rede assistencial diagnóstica e terapêutica; a preocupação com o grande número de demandas judiciais, tanto pela sustentabilidade econômica do sistema de saúde, quanto pela promoção de iniquidades; a pouca resolutividade dos benefícios sociais, uma vez que não atendem a todos aqueles que necessitam. A percepção é de que as medidas adotadas são insuficientes para garantir os direitos da pessoa com câncer no sistema de saúde brasileiro.
Collapse
|
7
|
Normanno N, Apostolides K, de Lorenzo F, Beer PA, Henderson R, Sullivan R, Biankin AV, Horgan D, Lawler M. Cancer Biomarkers in the era of precision oncology: Addressing the needs of patients and health systems. Semin Cancer Biol 2021; 84:293-301. [PMID: 34389490 DOI: 10.1016/j.semcancer.2021.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Cancer Biomarkers are the key to unlocking the promise of precision oncology, selecting which patients will respond to a more personalised treatment while sparing non-responders the therapy-related toxicity. In this paper, we highlight the primacy of cancer biomarkers, but focus on their importance to patients and to health systems. We also highlight how cancer biomarkers represent value for money. We emphasise the need for cancer biomarkers infrastructure to be embedded into European health systems. We also highlight the need to deploy multiple biomarker testing to deliver the optimal benefit for patients and health systems and consider cancer biomarkers from the perspective of cost, value and regulation. Cancer biomarkers must also be situated in the context of the upcoming In Vitro Diagnostics Regulation, which may pose certain challenges (e.g. non-compliance of laboratory developed tests, leading to cancer biomarker shortages and increased costs) that need to be overcome. Cancer biomarkers must be embedded in the real world of oncology delivery and testing must be implemented across Europe, with the intended aim of narrowing, not widening the inequity gap for patients. Cancer patients must be placed firmly at the centre of a cancer biomarker informed precision oncology care agenda.
Collapse
Affiliation(s)
- Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori - IRCCS - "Fondazione G. Pascale", Napoli, Italy
| | - Kathi Apostolides
- European Cancer Patient Coalition, Rue Montoyer 40, 1000, Brussels, Belgium
| | | | - Philip A Beer
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow, Scotland, G61 1QH, United Kingdom; Sanger Institute, Wellcome Trust Genome Campus, Cambridge, CB10 1SA, United Kingdom
| | - Raymond Henderson
- Diaceutics PLC, Belfast, United Kingdom; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, United Kingdom
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Guy's Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom
| | - Andrew V Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow, Scotland, G61 1QH, United Kingdom; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, G31 2ER, United Kingdom; South Western Sydney Clinical School, Goulburn St, Liverpool, NSW, 2170, Australia
| | - Denis Horgan
- European Alliance for Personalised Medicine, Avenue de l'Armee Legerlaan 10, 1040, Brussels, Belgium
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, United Kingdom.
| |
Collapse
|
8
|
Lawler M, De Lorenzo F, Lagergren P, Mennini FS, Narbutas S, Scocca G, Meunier F. Challenges and solutions to embed cancer survivorship research and innovation within the EU Cancer Mission. Mol Oncol 2021; 15:1750-1758. [PMID: 34053182 PMCID: PMC8253087 DOI: 10.1002/1878-0261.13022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/14/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
We have reached a watershed moment in Europe in our efforts to ensure increased survival and better outcomes for cancer patients. The EU Cancer Mission and the European Beating Cancer Plan together provide an unrivalled opportunity to make significant inroads into a disease that kills over 1.7 million European citizens annually. Harnessing these twin pillars of cancer research and cancer control can be transformative for the European cancer community and in particular for the European cancer patient. However, from a research perspective, in order to fully realise these benefits, we need to ensure that all aspects of the cancer continuum are addressed. Previous research efforts have focussed more on the diagnosis and treatment of cancer, whereas cancer survivorship, to date, has been overlooked. Here, we aim to redress this balance, by identifying the key challenges in cancer survivorship research that need to be addressed and proposing a series of recommended solutions, which, if acted upon, would deliver significant benefits for the nearly 20 million cancer survivors in Europe. To achieve this, we propose the development of a clearly articulated and sustainably funded European Cancer Survivorship Research and Innovation Plan. Embedding this plan within the framework of the EU Cancer Mission would be transformative for cancer survivors and society.
Collapse
Affiliation(s)
- Mark Lawler
- Patrick G Johnston Centre for Cancer ResearchQueen's University BelfastUK
- European Cancer OrganisationBrusselsBelgium
| | - Francesco De Lorenzo
- European Cancer Patient CoalitionBrusselsBelgium
- Italian Federation of Cancer Patients OrganisationsRomeItaly
| | - Pernilla Lagergren
- Surgical Care ScienceDepartment of Molecular Medicine and SurgeryKarolinska InstitutetKarolinska University HospitalStockholmSweden
- Department of Surgery and CancerImperial College LondonUK
| | - Francesco S. Mennini
- EEHTA CEIS, DEF DepartmentFaculty of EconomicsUniversity “Tor Vergata” RomeItaly
- Institute of Leadership and Management in HealthKingston UniversityLondonUK
| | | | | | | | | |
Collapse
|
9
|
Lawler M, Oliver K, Gijssels S, Aapro M, Abolina A, Albreht T, Erdem S, Geissler J, Jassem J, Karjalainen S, La Vecchia C, Lievens Y, Meunier F, Morrissey M, Naredi P, Oberst S, Poortmans P, Price R, Sullivan R, Velikova G, Vrdoljak E, Wilking N, Yared W, Selby P. The European Code of Cancer Practice. J Cancer Policy 2021; 28:100282. [DOI: 10.1016/j.jcpo.2021.100282] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022]
|
10
|
Franchina V, Cagnazzo C, Di Costanzo A, Arizio F, Frazzetto AME, Gori S, Cenna R, Nicolis F, Procopio G, Adamo V, La Verde N, Nanni O. Patient associations and clinical oncology research: how much does a patient's voice really matter? Expert Rev Pharmacoecon Outcomes Res 2020; 21:433-440. [PMID: 33201731 DOI: 10.1080/14737167.2021.1850274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: New trends are emerging in clinical research, such as patient empowerment and an active role in influencing health and research ethics. Patients' involvement is considered pivotal by stakeholders and institutions because they can channel the voice of those they represent, empowering their starring role in the different research activities.Objectives: To obtain an overview of the real involvement of Italian patient associations in clinical research.Methods: In January 2019, the Working Group 'Clinical Research Coordinators' of the Italian Association of Medical Oncology spread an online questionnaire consisting of 16 questions on the active involvement of patient associations in clinical research.Results: The involvement in clinical research working groups, in the organization and implementation of specific activities and training initiatives is very limited (21.7% in both cases), as well as the active involvement in the conduct and/or definition of clinical trials (0.3%). Moreover, few associations (15.2%) have joined projects on patient involvement in clinical research in collaboration with other associations.Discussion: Although the current involvement of the associations may have been somewhat underestimated, there is no doubt that much more can be done in terms of training and identification of common objectives between patients and professionals.
Collapse
Affiliation(s)
| | - Celeste Cagnazzo
- Unità Di Ricerca E Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città Della Salute E Della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento Di Scienze Della Sanità Pubblica E Pediatriche, Università Degli Studi Di Torino, Turin, Italy
| | | | | | | | - Stefania Gori
- Oncologia, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Rosita Cenna
- Unità Di Ricerca E Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città Della Salute E Della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento Di Scienze Della Sanità Pubblica E Pediatriche, Università Degli Studi Di Torino, Turin, Italy
| | - Fabrizio Nicolis
- Direzione Sanitaria, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Giuseppe Procopio
- Struttura Semplice Oncologia Medica Genitourinaria, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milano, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit, A.O. Papardo Messina, Messina, Italy.,Department of Human Pathology, University of Messina, Messina, Italy
| | - Nicla La Verde
- Oncologia, Ospedale Luigi Sacco - Polo Universitario, Milano, Italy
| | - Oriana Nanni
- Biostatistics and Clinical Trial Unit, Istituto Scientifico Romagnolo per Lo Studio E La Cura Dei Tumori (IRST) Srl, IRCCS, Meldola, Italy
| |
Collapse
|
11
|
Lawler M, Naredi P, Cufer T, Banks I, Lievens Y, Vassal G, Aapro M, Sotlar MJ, Philip T, Jassem J, Pelouchova J, Meunier F, Sullivan R. Moonshot or groundshot: addressing Europe's cancer challenge through a patient-focused, data-enabled lens. Lancet Oncol 2020; 20:1482-1485. [PMID: 31674308 DOI: 10.1016/s1470-2045(19)30648-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/09/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK.
| | - Peter Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tanja Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - Ian Banks
- Patient Advocacy Committee, European Cancer Organisation, Brussels, Belgium
| | - Yolande Lievens
- Radiation Oncology Department, Ghent University Hospital and Ghent University, Ghent, Belgium
| | | | - Matti Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | | | - Thierry Philip
- OECI Organization of European Cancer Institute and Institut Curie, Paris, France
| | | | | | | | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, King's College London, London, UK
| | | |
Collapse
|
12
|
Affiliation(s)
| | - Leonard L Berry
- Mays Business School, Texas A&M University, College Station, TX.,Institute for Healthcare Improvement, Boston, MA
| | - Patricia A Spears
- University of North Carolina Lineberger Comprehensive Cancer Center, Raleigh, NC
| | - Karina Dahl Steffensen
- Center for Shared Decision Making, Department of Clinical Oncology, Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark
| | - Deanna J Attai
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| |
Collapse
|
13
|
de Lorenzo F, Apostolidis K. The European Cancer Patient Coalition and its central role in connecting stakeholders to advance patient-centric solutions in the mission on cancer. Mol Oncol 2019; 13:653-666. [PMID: 30657631 PMCID: PMC6396363 DOI: 10.1002/1878-0261.12448] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/06/2019] [Indexed: 11/08/2022] Open
Abstract
There is an urgent need for solutions to the economic and social inequalities in cancer care that still exist in many European countries. Patient preferences, ‘big data’, mobile digital technology and molecular and genomic profiling are among the innovative research topics that connect cancer patients to comprehensive cancer centres, and link translational research to cancer diagnosis, treatment and care. The question is whether Europe can deliver the complex infrastructure needed for universal coverage and equitable access to cancer care. The European Cancer Patient Coalition (ECPC), the leading ‘umbrella’ cancer patient organisation in Europe, has a central role in bringing the unmet needs of patients with cancer to the forefront of cancer policy, care and research. The ECPC is a respected and reliable partner in the oncology community and has effectively collaborated with institutional stakeholders and organisations, as well as with the European Commission, on cancer research projects and in the development of tools to advance health care and cancer policies at the European and national level. The ECPC believes that innovation cannot emerge and grow without patient involvement and is fully committed to increasing patient education and contribution in cancer research through its active participation in various European cancer research programmes and educational resources. The ECPC is expected to play a major role in the mission on cancer, given its previous achievements in policy and research to help overcome the inequalities in cancer prevention, treatment, rehabilitation and survivorship care. The mission on cancer will be facilitated by active collaboration between patient organisations and scientists, clinicians, politicians and industry, with the aim of identifying important research questions regarding quality of life and social issues for cancer patients of all ages.
Collapse
|
14
|
Lagergren P, Schandl A, Aaronson NK, Adami HO, de Lorenzo F, Denis L, Faithfull S, Liu L, Meunier F, Ulrich C. Cancer survivorship: an integral part of Europe's research agenda. Mol Oncol 2019; 13:624-635. [PMID: 30552794 PMCID: PMC6396379 DOI: 10.1002/1878-0261.12428] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers’ efforts. It is time to increase the amount of attention given to patients’ long‐term well‐being and their ability to return to a productive and good life. This article describes the current state of knowledge and identifies research areas in need of development to enable interventions for improved survivorship for all cancer patients in Europe. The article is summed up with 11 points in need of further focus.
Collapse
Affiliation(s)
- Pernilla Lagergren
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Surgery and Cancer, Imperial College London, UK
| | - Anna Schandl
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Norway
| | - Francesco de Lorenzo
- European Cancer Patient Coalition, Brussels, Belgium.,Italian Federation of Cancer Patients Organisations, Rome, Italy
| | | | - Sara Faithfull
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Lifang Liu
- Fédération of European Academies of Medicine, Brussels, Belgium
| | | | - Cornelia Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | |
Collapse
|
15
|
Montroni I, Ugolini G, Saur NM, Spinelli A, Rostoft S, Millan M, Wolthuis A, Daniels IR, Hompes R, Penna M, Fürst A, Papamichael D, Desai AM, Cascinu S, Gèrard JP, Myint AS, Lemmens VE, Berho M, Lawler M, De Liguori Carino N, Potenti F, Nanni O, Altini M, Beets G, Rutten H, Winchester D, Wexner SD, Audisio RA. Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer. Eur J Surg Oncol 2018; 44:1685-1702. [DOI: 10.1016/j.ejso.2018.08.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/22/2018] [Accepted: 08/03/2018] [Indexed: 12/23/2022] Open
|
16
|
Abstract
The collection, storage and use of genomic and clinical data from patients and healthy individuals is a key component of personalised medicine enterprises such as the Precision Medicine Initiative, the Cancer Moonshot and the 100,000 Genomes Project. In order to maximise the value of this data, it is important to embed a culture within the scientific, medical and patient communities that supports the appropriate sharing of genomic and clinical information. However, this aspiration raises a number of ethical, legal and regulatory challenges that need to be addressed. The Global Alliance for Genomics and Health, a worldwide coalition of researchers, healthcare professionals, patients and industry partners, is developing innovative solutions to support the responsible and effective sharing of genomic and clinical data. This article identifies the challenges that a data sharing culture poses and highlights a series of practical solutions that will benefit patients, researchers and society.
Collapse
Affiliation(s)
- Mark Lawler
- a Centre for Cancer Research , Queen's University Belfast , Belfast , UK.,b Clinical Working Group , Global Alliance for Genomics and Health , Boston , USA
| | - Tim Maughan
- c CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford , Oxford , UK
| |
Collapse
|
17
|
Lawler M, Prue G, Banks I, Law K, Selby P, McVie G, Sullivan R. Mapping the cancer patient information landscape: A comparative analysis of patient groups across Europe and North America. Eur J Cancer 2018; 92:88-95. [PMID: 29428868 DOI: 10.1016/j.ejca.2018.01.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/15/2018] [Indexed: 11/30/2022]
Abstract
AIM Little is known about how patient groups provide information for patients. We invited 838 patient groups from Europe and North America to participate in an online survey. METHODS The survey covered: (i) availability, accessibility and quality of information provided; (ii) methods by which patient groups communicate; (iii) ways in which patient groups acquire information and confirm its veracity/accuracy; (iv) how people access information online. RESULTS European patient groups were significantly less effective in providing medical-related information than their North American counterparts in: clinical trials, potential causes of cancer, medical research, diagnosis/screening, symptoms, treatments (all p < 0.0001); Recommendations of best practice/care (p < 0.03), healthcare services(p = 0.029) and complimentary medicine (p = 0.01). Clinical trials (p = 0.0006), medical research (p = 0.006) and diagnosis/screening (p = 0.0024) were also areas where North American patients were more likely to require medical-related information. Similar patterns emerged for non-medical information with nutrition (<0.0001), watchful waiting (p = 0.0003), self-management of care (p = 0.0003), prevention (p = 0.002) and emotional issues (p = 0.016) being less effectively communicated by European patient groups. Nutrition was also an area where North American patients were more likely to require non-medical-related information. The main barriers in accessing online information which showed differences between European and North American patients were: perceived lack of need, mainly due to faith in their doctors (p = 0.0001); limited access to the internet (p = 0.0005), limited computer skills (p = 0.02); and lower income (p = 0.027). CONCLUSION These results emphasise the more mature nature of cancer patient engagement/information provision in North America, providing valuable insights and guidance to inform development of more robust and effective cancer patient information communication platforms in Europe.
Collapse
Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, UK; European Cancer Concord, Leeds, UK.
| | - Gillian Prue
- School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Ian Banks
- European Cancer Concord, Leeds, UK; Patient's Advocacy Committee, European Cancer Organisation, Brussels, Belgium
| | - Kate Law
- European Cancer Concord, Leeds, UK
| | - Peter Selby
- European Cancer Concord, Leeds, UK; Leeds Institute for Cancer and Pathology, University of Leeds, UK
| | - Gordon McVie
- Division of Cancer Studies, Kings' College London and eCancer, UK
| | - Richard Sullivan
- Institute of Cancer Policy, Division of Cancer Studies, Kings' College London and King's Health Partners Comprehensive Cancer Centre, London, UK
| |
Collapse
|
18
|
Lawler M, Alsina D, Adams RA, Anderson AS, Brown G, Fearnhead NS, Fenwick SW, Halloran SP, Hochhauser D, Hull MA, Koelzer VH, McNair AGK, Monahan KJ, Näthke I, Norton C, Novelli MR, Steele RJC, Thomas AL, Wilde LM, Wilson RH, Tomlinson I. Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. Gut 2018; 67:179-193. [PMID: 29233930 PMCID: PMC5754857 DOI: 10.1136/gutjnl-2017-315333] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes. DESIGN RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants. RESULTS Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders. CONCLUSION Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.
Collapse
Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
| | | | | | - Annie S Anderson
- Research into Cancer Prevention and Screening, University of Dundee, Dundee, UK
| | - Gina Brown
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | | | - Stephen W Fenwick
- Hepatobiliary Surgery Unit, Aintree University Hospital, Liverpool, UK
| | - Stephen P Halloran
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Daniel Hochhauser
- Department of Oncology, University College London Cancer Institute, London, UK
| | - Mark A Hull
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - Viktor H Koelzer
- Molecular and Population Genetics Laboratory, University of Oxford, Oxford, UK
| | - Angus G K McNair
- Centre for Surgical Research, University of Bristol, Bristol, UK
| | - Kevin J Monahan
- Family History of Bowel Cancer Clinic, Imperial College London, London, UK
| | - Inke Näthke
- School of Life Sciences, University of Dundee, Dundee, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Marco R Novelli
- Research Department of Pathology, University College London Medical School, London, UK
| | - Robert J C Steele
- Research into Cancer Prevention and Screening, University of Dundee, Dundee, UK
| | - Anne L Thomas
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Lisa M Wilde
- Bowel Cancer UK, London, UK
- Atticus Consultants Ltd, Croydon, UK
| | - Richard H Wilson
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
19
|
Abstract
OBJECTIVES The needs and rights awareness of stroke survivors have not been reported in China. This study investigated the needs and rights awareness of stroke survivors and caregivers in Tianjin, China. SETTING A survey launched by the World Stroke Organization was conducted in Tianjin, China. The questionnaire included demands for psychological support, treatment and care, social support and information. Stroke survivors and their caregivers were interviewed face to face for the questionnaire. Between June 2014 and February 2015, stroke survivors were invited to participate if they were more than 18 years old and had experienced a stroke. Exclusion criteria were patients who had disorders of consciousness, significant cognitive impairment, aphasia, communication difficulties or psychiatric disorders. Only caregivers who were family members of the patients were chosen. Paid caregivers were excluded. PARTICIPANTS Two hundred and forty-eight stroke survivors and 212 caregivers were enrolled. PRIMARY OUTCOME MEASURES The correlations between levels of needs and potential effect factors were analysed. Levels of different needs were compared by age, gender and time since stroke. RESULTS Among the cohort, 95.6% stroke survivors and 92.5% caregivers agreed to each question in the questionnaire. The participants prioritised the needs for psychological support (99.4%), treatment and care (98.6%), social support (98%) and information (96.2%). The total score was negatively correlated with age (r=-0.255, p<0.01). Patients below 65 years old had higher scores than those 65 years or older (p<0.01), while male patients had higher scores than female patients (p<0.01). CONCLUSIONS The needs for psychological and emotional support, individual treatment, social support and information about stroke were eagerly reported by most survivors. The Bill of Rights must be recognised by the Chinese society, providing appropriate stroke care to every patient to optimise stroke outcomes.
Collapse
Affiliation(s)
- Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilu Wang
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Shuting Zhang
- Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Liu
- Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Wang
- Department of Geratology, The Second Hospital of Tianjin Medical University and Tianjin Geriatric Institute, Tianjin, China
| |
Collapse
|
20
|
Lawler M, Banks I, Law K, Albreht T, Armand JP, Barbacid M, Barzach M, Bergh J, Cameron D, Conte P, de Braud F, de Gramont A, De Lorenzo F, Diehl V, Diler S, Erdem S, Geissler J, Gore-Booth J, Henning G, Højgaard L, Horgan D, Jassem J, Johnson P, Kaasa S, Kapitein P, Karjalainen S, Kelly J, Kienesberger A, La Vecchia C, Lacombe D, Lindahl T, Löwenberg B, Luzzatto L, Malby R, Mastris K, Meunier F, Murphy M, Naredi P, Nurse P, Oliver K, Pearce J, Pelouchov J, Piccart M, Pinedo B, Spurrier-Bernard G, Sullivan R, Tabernero J, Van de Velde C, van Herk B, Vedsted P, Waldmann A, Weller D, Wilking N, Wilson R, Yared W, Zielinski C, Zur Hausen H, Le Chevalier T, Johnston P, Selby P. The European Cancer Patient's Bill of Rights, update and implementation 2016. ESMO Open 2017; 1:e000127. [PMID: 28848664 PMCID: PMC5548978 DOI: 10.1136/esmoopen-2016-000127] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/24/2016] [Indexed: 11/04/2022] Open
Abstract
In this implementation phase of the European Cancer Patient's Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative:The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life.Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes.
Collapse
Affiliation(s)
- Mark Lawler
- Queen's University Belfast,; European Cancer Concord
| | - Ian Banks
- European Cancer Concord,; European Men's Health Forum,; University of Leeds
| | | | - Tit Albreht
- Institut za varovanje zdravja Republike Slovenija
| | | | - Mariano Barbacid
- Experimental Oncology, Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO)
| | | | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet
| | | | | | | | | | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations,; European Cancer Patient Coalition
| | | | | | | | - Jan Geissler
- Leukemia Patient Advocates Foundation,; European Patients Academy on Therapeutic Innovation
| | | | | | - Liselotte Højgaard
- Danmarks Grundforskningsfond,; Faculty of Health and Medical Sciences, Kobenhavns Universitet
| | | | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk
| | - Peter Johnson
- Department of Medical Oncology, University of Southampton,; Cancer Research UK
| | - Stein Kaasa
- Institute of Cancer Research and Molecular Medicine, Norges teknisk-naturvitenskapelige universitet
| | | | | | - Joan Kelly
- Association of European Cancer Leagues,; Irish Cancer Society
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Universita degli Studi di Milano
| | - Denis Lacombe
- European Organisation for Research and Treatment of Cancer
| | | | - Bob Löwenberg
- Department of Hematology, Erasmus University Medical Center
| | - Lucio Luzzatto
- Muhimbili University of Health and Allied Sciences,; Universita degli Studi di Firenze
| | - Rebecca Malby
- School of Health and Social Care, London South Bank University
| | | | | | - Martin Murphy
- European Cancer Concord, Society for Translational Oncology
| | - Peter Naredi
- Goteborgs Universitet,; European Cancer Organisation
| | | | | | | | | | | | | | | | - Richard Sullivan
- Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre
| | - Josep Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona
| | | | | | - Peter Vedsted
- Institute for Public Health and Department of Clinical Medicine, Aarhus Universitet
| | | | - David Weller
- Centre for Population Health Sciences, University of Edinburgh
| | - Nils Wilking
- Department of Oncology, Karolinska Institutet,; Skåne University Hospital
| | | | | | - Christoph Zielinski
- Comprehensive Cancer Center and Department of Medicine I, Medical University of Vienna,; European Society for Medical Oncology
| | | | | | | | - Peter Selby
- European Cancer Concord,; University of Leeds,.
| |
Collapse
|
21
|
Lawler M, French D, Henderson R, Aggarwal A, Sullivan R. Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care. Public Health Genomics 2016; 19:132-6. [DOI: 10.1159/000446530] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
22
|
Siu LL, Lawler M, Haussler D, Knoppers BM, Lewin J, Vis DJ, Liao RG, Andre F, Banks I, Barrett JC, Caldas C, Camargo AA, Fitzgerald RC, Mao M, Mattison JE, Pao W, Sellers WR, Sullivan P, Teh BT, Ward R, ZenKlusen JC, Sawyers CL, Voest EE. Facilitating a culture of responsible and effective sharing of cancer genome data. Nat Med 2016; 22:464-71. [PMID: 27149219 PMCID: PMC4995884 DOI: 10.1038/nm.4089] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 03/21/2016] [Indexed: 12/17/2022]
Abstract
Rapid and affordable tumor molecular profiling has led to an explosion of clinical and genomic data poised to enhance the diagnosis, prognostication and treatment of cancer. A critical point has now been reached at which the analysis and storage of annotated clinical and genomic information in unconnected silos will stall the advancement of precision cancer care. Information systems must be harmonized to overcome the multiple technical and logistical barriers to data sharing. Against this backdrop, the Global Alliance for Genomic Health (GA4GH) was established in 2013 to create a common framework that enables responsible, voluntary and secure sharing of clinical and genomic data. This Perspective from the GA4GH Clinical Working Group Cancer Task Team highlights the data-aggregation challenges faced by the field, suggests potential collaborative solutions and describes how GA4GH can catalyze a harmonized data-sharing culture.
Collapse
Affiliation(s)
- Lillian L. Siu
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Mark Lawler
- Centre for Cancer Research and Cell Biology, Queen’s University, Belfast, UK
| | - David Haussler
- UC Santa Cruz Genomics Institute, University of California, Santa Cruz, CA, USA
| | | | - Jeremy Lewin
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Daniel J. Vis
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rachel G. Liao
- The Global Alliance for Genomics and Health, Toronto, Canada and the Broad Institute, Cambridge, MA, USA
| | - Fabrice Andre
- Gustave Roussy and Université Paris Sud, Villejuif, France
| | - Ian Banks
- Patient’s Advocacy Committee, European Cancer Organization, Brussels, Belgium
| | - J. Carl Barrett
- Translational Sciences, Oncology iMED, AstraZeneca, Waltham, MA, USA
| | | | | | | | - Mao Mao
- Yonsei Cancer Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | | | - William Pao
- Roche Innovation Center Basel, Pharma Research and Early Development, Roche, Basel, Switzerland
| | | | - Patrick Sullivan
- Advocacy for Canadian Children Oncology Network, Vancouver, Canada
| | | | - Robyn Ward
- University of Queensland, St. Lucia, Australia
| | - Jean Claude ZenKlusen
- The Cancer Genome Atlas, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Emile E. Voest
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| |
Collapse
|
23
|
Selby P, Lawler M, Banks I, Johnston P, Nurse P. The EU: what's best for UK cancer research and patients? Lancet Oncol 2016; 17:556-7. [DOI: 10.1016/s1470-2045(16)30063-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/06/2016] [Indexed: 11/24/2022]
|