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Interventions to improve cancer screening adherence in migrants and ethnic minorities in the European Region: A systematic review. 改善欧洲地区移民和少数民族癌症筛查依从性的干预措施:一项系统综述。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-11 DOI: 10.1016/j.jcpo.2025.100677
Chiara De Marchi , Federica Di Lullo , Caterina Ferrari , Valentina Pettinicchio , Alessandra Sinopoli , Paolo lombardo , Maria Elena Tosti , Silvia Declich , Scilla Pizzarelli , Franca D’Angelo , Maria Teresa Riccardi , Fabiana Arrivi , Francesca Maria Forestiero , Virginia Rosca , Alessandra Romano , Daniela Marotta

Introduction

Adherence to cancer screening programs is crucial for reducing cancer-related mortality, yet migrant and ethnic minorities (MEMs) often show lower participation rates compared to the general population. This systematic review aims to identify effective strategies to improve cancer screening adherence among MEMs in the WHO European Region.

Methods

A systematic review was conducted following PRISMA guidelines, searching Medline, Embase, Scisearch, and Biosis for studies published up to October 13th, 2025. Eligible studies included quantitative and quali-quantitative studies focused on interventions aimed to increase adherence to cancer screening among MEMs. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools.

Results

We included 12 studies, conducted in the United Kingdom, Norway, Israel, and Turkey. All of the interventions focused on breast and cervical cancer screening, with no studies addressing colorectal cancer screening. Effective interventions incorporated culturally and linguistically tailored strategies, such as community-based education, use of cultural mediators, multilingual reminds and information, free transport service and language support. Community-based and informal health education approaches significantly increased screening uptake, particularly among South Asian and ultraOrthodox Jewish women. However, interventions targeting men or colorectal cancer screening were lacking, indicating a significant research gap.

Policy Summary

This review highlights the need for gender-inclusive, culturally sensitive policies to improve screening adherence among MEMs. Policymakers should develop integrated screening campaigns that address multiple cancer types, particularly colorectal cancer, and ensure the inclusion of male populations. Enhancing community involvement is essential to achieve equitable screening coverage in line with EU health targets.
导读:坚持癌症筛查计划对于降低癌症相关死亡率至关重要,然而与普通人群相比,移民和少数民族(MEMs)的参与率往往较低。本系统综述旨在确定提高世卫组织欧洲区域MEMs癌症筛查依从性的有效策略。方法:按照PRISMA指南进行系统评价,检索Medline、Embase、Scisearch和Biosis,检索截至2025年10月13日发表的研究。符合条件的研究包括定量和定性定量研究,重点关注旨在提高MEMs癌症筛查依从性的干预措施。使用乔安娜布里格斯研究所关键评估工具评估研究质量。结果:我们纳入了在英国、挪威、以色列和土耳其进行的12项研究。所有的干预措施都集中在乳腺癌和宫颈癌筛查上,没有针对结直肠癌筛查的研究。有效的干预措施包括针对文化和语言的战略,如基于社区的教育、使用文化媒介、多语种提醒和信息、免费交通服务和语言支持。以社区为基础和非正式的健康教育方法显著提高了筛查的接受程度,特别是在南亚和极端正统派犹太妇女中。然而,针对男性或结直肠癌筛查的干预措施缺乏,表明研究存在重大空白。政策总结:本综述强调需要制定性别包容、文化敏感的政策,以提高MEMs的筛查依从性。决策者应开展针对多种癌症类型的综合筛查活动,特别是结肠直肠癌,并确保纳入男性人群。加强社区参与对于实现符合欧盟卫生目标的公平筛查覆盖率至关重要。
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引用次数: 0
The health and economic burden of lung cancer in Australia: A dynamic model of quality of life and productivity loss 澳大利亚肺癌的健康和经济负担:生活质量和生产力损失的动态模型。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-10 DOI: 10.1016/j.jcpo.2025.100674
Mohammad Afshar Ali , Christine Y. Lu

Background

Prior studies estimated lung cancer costs; none examined quality of life and work productivity in Australia via population-based models.

Objective

Quantify lung cancer’s burden in working-age Australians using a dynamic Markov lifetable, estimating quality-adjusted life years (QALYs) and productivity-adjusted life years (PALYs) lost.

Methods

We developed a dynamic comparative Markov lifetable model to simulate both incident and prevalent cases of lung cancer among Australians aged 20–64 years from 2022 to 2031. Two parallel scenarios were modelled: (i) a base-case scenario reflecting individuals diagnosed in 2022 (incident model) and those living with lung cancer from 2012 to 2021 (prevalent model), and (ii) a counterfactual scenario in which no individuals had lung cancer. The differences between these simulations were used to estimate life years, QALYs, and PALYs lost. Model inputs were derived from previously published data. The economic value of productivity losses was estimated using the 2022 Australian gross domestic product (GDP) per full-time equivalent worker, applying a 5 % annual discount rate.

Results

Over the twenty-year period, lung cancer is projected to result in the loss of 28,430 life years, 55,964 QALYs, and 60,310 PALYs, equating to AU$14.45 billion in lost GDP. Sensitivity analyses confirmed the robustness of the model to variations in key parameters.

Conclusion

Lung cancer imposes a substantial health and economic burden among working-age Australians. By combining QALY and PALY metrics within a dynamic modelling framework, this study provides a comprehensive assessment of the burden faced by this population and may inform future research and economic evaluations.
背景:先前的研究估算了肺癌的成本;没有人通过基于人口的模型来研究澳大利亚的生活质量和工作效率。目的:使用动态马尔可夫生命表量化工作年龄澳大利亚人的肺癌负担,估计质量调整生命年(QALYs)和生产力调整生命年(PALYs)损失。方法:我们开发了一个动态比较马尔可夫生命表模型来模拟2022年至2031年间20-64岁澳大利亚人肺癌发病率和流行病例。模拟了两种平行情景:(i)反映2022年确诊的个体(事件模型)和2012年至2021年患有肺癌的个体(流行模型)的基本情景情景,以及(ii)没有个体患有肺癌的反事实情景。这些模拟之间的差异被用来估计生命年、QALYs和PALYs的损失。模型输入来自先前发布的数据。生产力损失的经济价值是用2022年澳大利亚每个全职等效工人的国内生产总值(GDP)来估算的,采用5%的年折扣率。结果:在20年的时间里,肺癌预计将导致28430个生命年、55,964个质量年和60,310个paly年的损失,相当于144.5亿澳元的GDP损失。敏感性分析证实了模型对关键参数变化的鲁棒性。结论:肺癌给工作年龄的澳大利亚人带来了巨大的健康和经济负担。通过在动态建模框架内结合QALY和PALY指标,本研究对这一人群面临的负担进行了全面评估,并可能为未来的研究和经济评估提供信息。
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引用次数: 0
Ensuring equitable access to cancer medicine and care in Australia: A human-rights lens, including people experiencing homelessness 确保在澳大利亚公平获得癌症药物和护理:人权视角,包括无家可归者
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-09 DOI: 10.1016/j.jcpo.2025.100678
Rashidul Alam Mahumud
Australia has strong cancer survival. Yet many people still struggle to get timely diagnosis, medicines, and supportive care. Gaps are widest for Aboriginal and Torres Strait Islander peoples, rural and remote communities, culturally and linguistically diverse groups, people with disability, temporary visa holders, and people experiencing homelessness.

Objective

To set out practical, rights-aligned actions that turn universal coverage into universal access.

Approach

This short communication applies a rights-based analytic framing, distinct from a checklist, to reinterpret policy choices through the lenses of accountability, justiciability, and participation.

Actionable implications

Using this framing, synthesising recent evidence on affordability, diagnostics, and service capacity, we prioritise four actionable levers: cap financial toxicity (with standardised travel/accommodation support and public OOP reporting); fund and benchmark companion diagnostics (national turnaround and equity dashboards); scale tele-oncology/tele-trials with minimum local capacity and travel stipends (monitoring priority populations); and adopt distributional cost-effectiveness analysis in HTA and program design to make equity trade-offs explicit. This framing specifies who must act, by when, and with what evidence, offering a practical route to equitable, sustainable cancer.

Conclusion

Universal coverage alone does not guarantee equity. Implementing a rights-aligned plan with clear duty-bearers, timelines, and the four actionable levers we outline can narrow access gaps and support timely, affordable, culturally safe cancer care, including for people experiencing homelessness.
澳大利亚的癌症存活率很高。然而,许多人仍然难以获得及时的诊断、药物和支持性护理。土著人和托雷斯海峡岛民、农村和偏远社区、文化和语言多样化群体、残疾人、临时签证持有人和无家可归者的差距最大。目标:制定切合实际、符合权利的行动,将全民覆盖转变为普遍可及。方法本简短沟通采用基于权利的分析框架,不同于清单,通过问责制、可诉性和参与的视角重新解释政策选择。可操作的影响利用这一框架,综合最近关于可负担性、诊断和服务能力的证据,我们优先考虑了四个可操作的杠杆:限制财务毒性(通过标准化的旅行/住宿支持和公共OOP报告);基金和基准配套诊断(国家周转和股票仪表板);以最低限度的当地能力和旅费津贴进行远程肿瘤学/远程试验(监测重点人群);并在HTA和方案设计中采用分配成本效益分析,以明确股权权衡。这一框架规定了谁必须采取行动,在什么时候采取行动,以什么证据采取行动,为实现公平、可持续的癌症提供了一条切实可行的途径。结论仅全民覆盖并不能保证公平。实施一项与权利相一致的计划,明确责任承担者、时间表和我们概述的四个可操作杠杆,可以缩小获取差距,并支持及时、负担得起、文化上安全的癌症治疗,包括为无家可归者提供癌症治疗。
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引用次数: 0
Economic evaluation of the one-dose HPV vaccination program in Nigeria 尼日利亚单剂HPV疫苗接种计划的经济评价。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-06 DOI: 10.1016/j.jcpo.2025.100675
Tianjiao Gao , Marwa Farag , Sohail Agha , Linda Mobula , Xiaohui Hou , Guohong Li , Wu Zeng

Background

This study retrospectively examines the cost-effectiveness of the national HPV vaccination program using the program cost and coverage data in Nigeria.

Methods

We conducted a cost-effectiveness analysis of the HPV vaccination program compared with no vaccination in Nigeria, adopting both health system and societal perspectives. A static Markov model simulating HPV infection and cervical cancer outcomes was developed for a cohort of girls aged 9–14 years, followed until age 100. The model comprised primarily the following health states: susceptible, cervical cancer, and death. It further incorporated three additional pathways for patients with cervical cancer, including those with successful treatment, with treatment failure, and with no treatment.

Results

The incremental cost-effectiveness ratio (ICER) was estimated at $268.67 per quality-adjusted life year (QALY) gained from the health system perspective and $217.85 per QALY gained from the societal perspective. Both ICERs were well below the cost-effectiveness threshold of one-time GDP per capita in Nigeria ($806.95). Key drivers of cost-effectiveness included vaccine cost, treatment success rate, cervical cancer treatment coverage, and cervical cancer utility values.

Discussion

The single-dose HPV vaccination program is highly cost-effective in Nigeria, compared to the status quo of no vaccination. To ensure long-term sustainability, the Nigerian government should strengthen financing mechanisms and the healthcare system to support the program.

Policy Summary

Single dose HPV vaccination is cost-effective in Nigeria. It is crucial to obtain sustainable vaccine financing and improve treatment to maintain the program impact.
背景:本研究利用尼日利亚的HPV疫苗接种计划成本和覆盖率数据,回顾性地考察了国家HPV疫苗接种计划的成本效益。方法:我们从卫生系统和社会角度对尼日利亚HPV疫苗接种计划与未接种疫苗进行了成本效益分析。一个模拟HPV感染和宫颈癌结果的静态马尔可夫模型被建立在9-14岁的女孩队列中,直到100岁。该模型包括三种健康状态:易感、宫颈癌和死亡。它还为宫颈癌患者增加了三种途径,包括治疗成功、治疗失败和未治疗的宫颈癌患者。结果:从卫生系统角度估计,每个质量调整生命年(QALY)的增量成本-效果比(ICER)为268.67美元,从社会角度估计,每个质量调整生命年(QALY)的增量成本-效果比为217.85美元。这两个ICERs都远低于尼日利亚一次性人均GDP的成本效益门槛(806.95美元)。成本效益的主要驱动因素包括疫苗成本、治疗成功率、宫颈癌治疗覆盖率和宫颈癌效用值。讨论:与不接种疫苗的现状相比,单剂HPV疫苗接种计划在尼日利亚具有很高的成本效益。为确保长期可持续性,尼日利亚政府应加强融资机制和医疗保健系统,以支持该计划。政策摘要:单剂HPV疫苗接种在尼日利亚具有成本效益。至关重要的是获得可持续的疫苗融资和改善治疗,以保持规划的影响。
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引用次数: 0
Advancing equity for people with intellectual disabilities: Closing the neglected cancer policy gap 促进智障人士的公平:缩小被忽视的癌症政策差距。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-05 DOI: 10.1016/j.jcpo.2025.100672
Martin McMahon , Suzanne Denieffe, Kate Sykes, Peter Knapp, Maarten Cuypers, Pınar Soylar, Adela Elena Popa, Dalia Ismail Ibrahim, Bahar Aksoy, Seda Cansu Yeniğün Akbulut, Katerina Flora, Soner Dogan, Bilge Güvenç Tuna, Ayşegül Ilgaz, Gunilla Kulla, Jasmin Mušanović, Rebecca Hansford, Amina Banda, Derya Özalp Ünal, Özge İşeri, Vladimir Vukovic
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引用次数: 0
Quality improvement initiatives on colposcopy and treatment of cervical pre-cancer services in Bhutan: Experiences, challenges, and way forward 质量改进举措阴道镜检查和治疗宫颈癌前服务在不丹:经验,挑战和前进的道路
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-04 DOI: 10.1016/j.jcpo.2025.100676
Namkha Dorji, Thinley Dorji, Yeshey Dorjey, Yangdon Yangdon
Bhutan has achieved 90–70–90 global targets by 2023, way ahead of the global targets of elimination of cervical cancer by 2030. However, cervical cancer remains the most prevalent cancer, among women in Bhutan. While all healthcare screening, diagnosis and treatment of cervical cancers are provided free of cost, sustainability in terms of financing and human resources and ensuring quality of services are the major challenges. Development of a national standard guideline is a major intervention towards improving the quality of colposcopy services and treatment of precancer in the country. In this article, we discuss the summary of the consensus-based practical guideline on colposcopy and treatment of cervical pre-cancers in Bhutan, challenges faced and potential way forward.
不丹到2023年实现了90-70-90的全球目标,远远超过了到2030年消除宫颈癌的全球目标。然而,在不丹妇女中,子宫颈癌仍然是最普遍的癌症。虽然宫颈癌的所有保健检查、诊断和治疗都是免费提供的,但在资金和人力资源方面的可持续性以及确保服务质量是主要挑战。制定国家标准指南是提高国内阴道镜检查服务质量和癌前病变治疗的一项主要干预措施。在这篇文章中,我们讨论了基于共识的实用指南总结阴道镜检查和治疗宫颈癌前病变在不丹,面临的挑战和潜在的前进道路。
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引用次数: 0
Evidence on vaping e-cigarettes as a risk factor for cancer: A cautionary tale in flawed synthesis 电子烟作为癌症风险因素的证据:一个有缺陷的合成的警世故事。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-04 DOI: 10.1016/j.jcpo.2025.100673
Red Thaddeus D. Miguel, Isabella Steffensen
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引用次数: 0
Understanding the development process of national cancer control plans in low- and middle-income countries. 了解中低收入国家国家癌症控制计划的制定过程。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 DOI: 10.1016/j.jcpo.2025.100670
Linsey Eldridge, Amina Chtourou, Kalina Duncan, Leslie Given, Sana Haider, Karin Hohman, Douglas M Puricelli Perin, Yannick Romero, Zuzanna Tittenbrun, Mishka Kohli Cira

Background: As cancer incidence in low- and middle-income countries (LMICs) continues to rise, the development of National Cancer Control Plans (NCCP) has become an essential policy tool for guiding a comprehensive and coordinated response. The NCCP Development Research Initiative (NCCP DRIVE) is a qualitative study led by the International Cancer Control Partnership (ICCP) to understand the NCCP development process and contextual factors that may enable or impede effective NCCP development.

Methods: In-depth interviews were conducted with country-level cancer planners in nine countries (seven African, two South Asian) within the ICCP network. Transcripts were recorded, transcribed, and double-coded in Dedoose, then analyzed thematically using the Health Policy Triangle (HPT) framework.

Results: Findings highlight that NCCP development is dynamic and iterative, following six commonly reported phases: Initiation, Formulation, Negotiation, Communication, Implementation, and Monitoring/Evaluation. Common challenges reported by respondents included limited financial and human resources, competing priorities, fragmented health systems, and inadequate data. These constraints led to compressed timelines, overlapping planning activities, and gaps in costing and implementation plans. To address these challenges, respondents employed various strategies, including integrating cancer control efforts with existing health programs, engaging multisector actors, building political will, and securing technical assistance (TA) from partners. Building partnerships was pivotal, helping to set priorities, align plans with national and global agendas, and leverage resources. However, some respondents reported misaligned timelines and priorities, and coordination challenges.

Conclusion: This study contributes a policy framework-informed, implementation-focused analysis of NCCP development, offering practical insights into how countries navigate complex challenges to initiate and sustain cancer control planning. Findings underscore the need for flexible TA models and stronger data systems, and the value of integrating cancer control priorities within existing health systems. Understanding these dynamics from initiation to implementation offers practical insights for countries at various stages of development, and for partners providing technical assistance.

背景:随着低收入和中等收入国家(LMICs)癌症发病率的持续上升,国家癌症控制计划(NCCP)的制定已成为指导全面协调应对的重要政策工具。NCCP发展研究倡议(NCCP DRIVE)是由国际癌症控制伙伴关系(ICCP)领导的一项定性研究,旨在了解NCCP的发展过程以及可能促进或阻碍NCCP有效发展的背景因素。方法:对ICCP网络内9个国家(7个非洲国家,2个南亚国家)的国家级癌症规划人员进行了深入访谈。在Dedoose中记录、转录和双重编码转录本,然后使用健康政策三角(Health Policy Triangle, HPT)框架进行主题分析。结果:研究结果强调了NCCP的发展是动态的和迭代的,遵循六个通常报道的阶段:启动、制定、谈判、沟通、实施和监测/评估。答复者报告的共同挑战包括有限的财政和人力资源、相互竞争的优先事项、分散的卫生系统和不充分的数据。这些限制因素导致了时间表的压缩、计划活动的重叠以及成本和实施计划的差距。为了应对这些挑战,受访者采用了各种策略,包括将癌症控制工作与现有卫生规划结合起来,让多部门行为者参与进来,建立政治意愿,以及从合作伙伴那里获得技术援助。建立伙伴关系至关重要,有助于确定优先事项,使计划与国家和全球议程保持一致,并利用资源。然而,一些答复者报告了时间表和优先事项不一致以及协调方面的挑战。结论:本研究为非传染性疾病的发展提供了政策框架信息,以实施为重点的分析,为各国如何应对复杂的挑战,启动和维持癌症控制计划提供了实际见解。研究结果强调需要灵活的临床经验模型和更强大的数据系统,以及将癌症控制重点纳入现有卫生系统的价值。了解从启动到实施的这些动态,可以为处于不同发展阶段的国家和提供技术援助的合作伙伴提供实际的见解。
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引用次数: 0
Response to ‘beyond virtual learning: Leveraging project ECHO to sustain and localize national cancer control plan implementation in LMICs’ 对“超越虚拟学习:利用ECHO项目维持和本地化中低收入国家癌症控制计划的实施”的回应。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 DOI: 10.1016/j.jcpo.2025.100639
Linsey Eldridge, Kalina Duncan, Mishka Kohli Cira
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引用次数: 0
Corrigendum to “Bridging the equity gap in colorectal cancer screening: A comparative analysis across high-income countries” [J. Cancer Policy 46 (2025) 100657] “弥合结直肠癌筛查的公平差距:高收入国家的比较分析”[J]。癌症政策46(2025)[100657]。
IF 2 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-12-01 DOI: 10.1016/j.jcpo.2025.100667
Yasmin Jahan , Atiqur SM-Rahman
{"title":"Corrigendum to “Bridging the equity gap in colorectal cancer screening: A comparative analysis across high-income countries” [J. Cancer Policy 46 (2025) 100657]","authors":"Yasmin Jahan ,&nbsp;Atiqur SM-Rahman","doi":"10.1016/j.jcpo.2025.100667","DOIUrl":"10.1016/j.jcpo.2025.100667","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100667"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Cancer Policy
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