Global disparities in cancer supportive care: An international survey

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-09-13 DOI:10.1002/cam4.70234

Alexandre Chan, Lawson Eng, Changchuan Jiang, Mary Dagsi, Yu Ke, Mary Tanay, Cristiane Bergerot, Niharika Dixit, Ana Cardeña Gutiérrez, Ana I. Velazquez, Farhad Islami, Enrique Soto-Perez-de-Celis

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Abstract

Background

The global cancer burden is rising, particularly in low- and middle-income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High-Income Countries (HIC).

Methods

An online cross-sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice-related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi-squared or Fisher's exact test for cross-sectional analyses, and a multivariable logistic regression model was employed for statistical analysis.

Results

A total of 218 active members participated, with one-quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non-US-based) respondents, while US-based respondents identified racial/ethnic minorities as facing more disparities.

Conclusion

This global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.

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癌症支持性护理的全球差异：一项国际调查

背景全球癌症负担日益加重，尤其是在中低收入国家（LMIC），这凸显了在了解支持性护理获取方面的差距方面存在着严重的研究空白。为解决这一问题，多国癌症支持性治疗协会（MASCC）健康差异委员会发起了一项全球调查，以调查和界定这些差异。本研究旨在探索和比较低收入国家（LMIC）和高收入国家（HIC）在获得支持性护理方面的差距。方法对 MASCC 的活跃会员进行了一项在线横断面调查。代表不同医疗保健专业的会员收到了电子邮件邀请。调查为期 3 周，内容包括：(1) 社会人口学信息；(2) 所在地区/国家与临床服务/实践相关的差异；(3) 所在地区或国家面临差异的人群。截面分析采用卡方检验或费雪精确检验，统计分析采用多变量逻辑回归模型。结果共有 218 名活跃成员参与，其中四分之一（26.6%）来自低收入和中等收入国家，18.4%为少数民族，及时的癌症护理（43.7%）和及时的支持性护理（45.0%）成为全球最紧迫的差距。值得注意的是，来自低收入和中等收入国家的与会者强调，癌症药物的可负担性（56.4%）和支持性护理指南的实施（56.4%）是关键问题。低收入和中等收入国家以及高收入国家（非美国）的受访者均指出，经济条件较差的人群更有可能面临差异，而美国的受访者则认为少数种族/民族面临更多差异。结论本次全球调查显示，低收入和中等收入国家与高收入国家在癌症支持性治疗方面存在显著差异，尤其是在低收入和中等收入国家的药物可负担性和指南实施方面。要解决这些差距，就需要考虑特定地区的优先事项，采取有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.