The Greatest Healthcare Disparity: Addressing Inequities in the Treatment of Childhood Central Nervous System Tumors in Low- and Middle-Income Countries.

Jordan T Roach, Nathan A Shlobin, Jared M Andrews, Ronnie E Baticulon, Danny A Campos, Daniel C Moreira, Ibrahim Qaddoumi, Frederick A Boop
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Abstract

The antithesis between childhood cancer survival rates in low- and middle-income countries (LMIC) and high-income countries (HIC) represents one of healthcare's most significant disparities. In HICs, the 5-year survival rate for children with cancer, including most brain tumors, exceeds 80%. Unfortunately, children in LMICs experience far worse outcomes with 5-year survival rates as low as 20%. To address inequities in the treatment of childhood cancer and disease burden globally, the World Health Organization (WHO) launched the Global Initiative for Childhood Cancer. Within this initiative, pediatric low-grade glioma (LGG) represents a unique opportunity for the neurosurgical community to directly contribute to a paradigm shift in the survival outcomes of children in LMICs, as many of these tumors can be managed with surgical resection alone. In this chapter, we discuss the burden of pediatric LGG and outline actions the neurosurgical community might consider to improve survival for children with LGG in LMICs.

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医疗保健差距最大:解决中低收入国家儿童中枢神经系统肿瘤治疗的不公平问题。
低收入和中等收入国家(LMIC)和高收入国家(HIC)的儿童癌症存活率之间的对立代表了医疗保健最显著的差异之一。在HICs中,癌症儿童(包括大多数脑肿瘤)的5年生存率超过80%。不幸的是,LMIC的儿童经历了更糟糕的结果,5年生存率低至20%。为了解决全球儿童癌症治疗方面的不公平和疾病负担问题,世界卫生组织(世界卫生组织)发起了儿童癌症全球倡议。在这一举措中,儿童低级别神经胶质瘤(LGG)为神经外科界提供了一个独特的机会,可以直接促进LMIC儿童生存结果的范式转变,因为其中许多肿瘤可以单独通过手术切除来治疗。在本章中,我们讨论了儿童LGG的负担,并概述了神经外科社区可能考虑采取的行动,以提高LMIC中LGG儿童的生存率。
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