Journal of Cancer Policy最新文献

{"title":"Population-Based Cancer Screening analysis in Northern Portugal Using Process Mining","authors":"Hugo Monteiro ,&nbsp;Mariana Oliveira ,&nbsp;Ricardo Martinho ,&nbsp;João Reis ,&nbsp;Fernando Tavares ,&nbsp;Óscar Felgueiras ,&nbsp;Carlos Martins","doi":"10.1016/j.jcpo.2026.100702","DOIUrl":"10.1016/j.jcpo.2026.100702","url":null,"abstract":"<div><h3>Background</h3><div>This study focuses on the Colorectal Cancer Screening Program in Northern Portugal, aiming to evaluate the disruption effects on its performance and efficiency.</div></div><div><h3>Methods</h3><div>We conducted an observational analyses of 271 637 administrative records from 2020 to 2022. Administrative timestamps were converted into a step-by-step dataset of screening activities (an “event log”) and analysed using process mining and comparative performance analysis across time periods and ACeS (primary care administrative clusters).</div></div><div><h3>Results</h3><div>Consultation‑to‑colonoscopy time lengthened by 53 %, rising from a median 58 days (IQR 29–92) in early 2020 to 89 days (IQR 53–127) in 2021, before improving to 73 days in 2022. Conversely, referral‑to‑consultation time fell from 110 days to 26 days (−76 %), reflecting targeted backlog clearance. Screening volumes declined in 2020 but recovered above baseline levels by 2022. Performance differences across primary care administrative clusters were significant (p &lt; 0.001), with some units outperforming regional median transition times. Early adoption of automated electronic referrals and flexible consultation scheduling may have contributed to improved programme performance during the recovery period following pandemic-related disruptions. Substantial heterogeneity across units was observed for key transitions, indicating uneven disruption and recovery patterns across administrative units.</div></div><div><h3>Conclusion</h3><div>Process Mining techniques revealed critical vulnerabilities in the screening program during the initial stages of the period in analysis (matching the pandemic). These findings support targeted monitoring and prioritisation of operational improvements to reduce avoidable delays and strengthen continuity of population-based screening.</div></div><div><h3>Policy summary</h3><div>Policies aimed at strengthening healthcare service continuity and operational capacity benefit from analytical methods like process mining. Key recommendations include standardizing workflows, enhancing coordination between primary care and hospital services, and investing in digital monitoring systems to mitigate disruptions and ensure continuity in cancer screening programs during periods of system stress.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100702"},"PeriodicalIF":2.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918884","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}

{"title":"Current opinions on lung cancer screening in the Nordic countries: A survey-based study","authors":"Morten Borg ,&nbsp;Kirill Neumann ,&nbsp;Jannie Christina Frølund ,&nbsp;Ghida Khalife ,&nbsp;Zaigham Saghir ,&nbsp;Aija Knuuttila ,&nbsp;Haseem Ashraf ,&nbsp;Johan Isaksson ,&nbsp;Torben Riis Rasmussen","doi":"10.1016/j.jcpo.2026.100703","DOIUrl":"10.1016/j.jcpo.2026.100703","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer-related death worldwide, with early detection critical for curative treatment. Low-dose computed tomography (LDCT) can detect lung cancer at earlier stages, but its implementation in the Nordic countries remains limited. This study surveys invasive respiratory physicians in Sweden, Finland, Norway, and Denmark to explore their views on LDCT screening.</div></div><div><h3>Methods</h3><div>A web-based survey was conducted among invasive respiratory physicians in Denmark, Norway, Sweden, and Finland to assess opinions on lung cancer screening. Responses were analysed using descriptive statistics and the Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>A total of 125 respondents from 54 Nordic hospitals completed the survey. The majority reported no prior experience with LDCT screening. Most physicians were familiar with LDCT and recognized its potential to improve early detection, though opinions on national implementation were mixed. Key barriers identified included financial constraints, lack of trained personnel, and limited access to CT scanners. Significant differences were observed by country, hospital type, and years of clinical experience (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Nordic respiratory physicians acknowledge the benefits of LDCT screening for early lung cancer detection but highlight substantial implementation challenges, particularly related to resources and personnel. Addressing these barriers, standardizing protocols, and exploring supportive measures such as risk-scores and AI-assisted imaging will be essential for successful adoption of national screening programs across the Nordic region.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100703"},"PeriodicalIF":2.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918859","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}

{"title":"Geographic disparities in access to oncologists and association with cancer outcomes in the United States","authors":"Ryan J. Crowley ,&nbsp;Jag S. Lally ,&nbsp;David M. Kline ,&nbsp;Amanda M. Bunting","doi":"10.1016/j.jcpo.2026.100704","DOIUrl":"10.1016/j.jcpo.2026.100704","url":null,"abstract":"<div><h3>Background</h3><div>Access to oncologists is crucial to quality cancer care. We aimed to assess the geospatial distribution of oncologists in the United States and its association with cancer mortality.</div></div><div><h3>Methods</h3><div>We used county-level oncologist data from the 2025 Doctors and Clinicians national downloadable file and county-level cancer outcome data from the 2018–2022 State Cancer Profiles. We assessed urban-rural differences in the distribution of oncologists in the United States and used Local Moran’s I to identify clusters of high and low oncologist density and cancer mortality rates. We classified counties using the 2023 Rural-Urban Continuum Codes (RUCC) with RUCC 1–3 as urban and RUCC 4–9 as rural.</div></div><div><h3>Results</h3><div>13,332 oncologists were identified nationwide. The median oncologist density per 100,000 population was 6.0 in urban counties and 0.0 in rural counties (p-value &lt;0.001). The median age-adjusted cancer mortality rate per 100,000 population was 156.1 in urban counties and 166.8 in rural counties (p-value &lt;0.001). Clusters of low oncologist density were observed in the South.</div></div><div><h3>Conclusion</h3><div>There are significant geospatial differences in oncologist accessibility and cancer outcomes. Targeted interventions are necessary to ensure that rural areas maintain access to oncology care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100704"},"PeriodicalIF":2.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917518","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}

{"title":"Social framework to judge the importance of breast cancer","authors":"Zsuzsa Réka Pozsár ,&nbsp;Krisztina Tóth ,&nbsp;Marianna Moizs ,&nbsp;János Révész ,&nbsp;Klára Tatár-Kiss ,&nbsp;Judit Tittmann ,&nbsp;Aliz Nikolényi ,&nbsp;Ágnes Anna Kovács ,&nbsp;Tamás Mátrai ,&nbsp;Borbála Judit Szabó ,&nbsp;Erzsébet Hajduné Kovács ,&nbsp;Csilla Czene ,&nbsp;Dalma Hosszú ,&nbsp;Anna Bögös ,&nbsp;Tu Thanh Nguyen ,&nbsp;Júlia Zemplényiné Bartha ,&nbsp;Tamás Ágh ,&nbsp;Zoltán Kaló ,&nbsp;Magdolna Dank","doi":"10.1016/j.jcpo.2025.100679","DOIUrl":"10.1016/j.jcpo.2025.100679","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) has profound effects on patients, households, and society, necessitating a multidimensional approach to understand its implications fully. This study aimed to develop a conceptual model for a social framework (SF) that assists in identifying group common values and needs for BC interventions in Hungary. The SF reflects diverse perspectives, including healthcare professionals, patients, caregivers, policymakers of health and social care, health technology developers, and corporate and philanthropic supporters of BC initiatives.</div></div><div><h3>Methods</h3><div>A narrative literature review was conducted to identify value elements (VEs) of BC. VEs were categorized into groups and further clustered into sub-groups within each main category. This literature-based conceptual model was contextualized and adapted to the Hungarian setting through individual and group interviews with various societal group representatives. A closing validation meeting fostered stakeholders’ reflection on the draft model.</div></div><div><h3>Results</h3><div>The final conceptual model incorporates five traditional (e.g., clinical outcomes, adverse events, survival, and direct medical costs), nine patient-centric (e.g., personal milestones, patient experience, and financial burden), and seven societal (e.g., disease severity, the presence of the disease around us, and indirect costs) VEs.</div></div><div><h3>Conclusion</h3><div>Our study is the first to present a comprehensive SF that provides insights into key disease challenges and why different BC interventions are important to various stakeholder groups via capturing traditional, patient-centric, and societal VEs. It informs decision-making within and beyond the healthcare domain by supporting the evaluation of policies, health technologies, public and civil society initiatives in Hungary.</div></div><div><h3>Policy Summary</h3><div>While BC is a priority disease area for all stakeholder groups, their views on what contributes to the success of policy decisions are different. If policymakers intend to represent the interests of the whole society, they should aim to express the value of policy interventions in a comprehensive SF.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100679"},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828480","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}

{"title":"Progression-free survival is strongly associated with overall survival in relapsed/refractory diffuse large B-cell lymphoma in the CAR T-cell era","authors":"Alexander M. Gorzewski ,&nbsp;Rebecca Z. Steuer ,&nbsp;Charmi Trivedi ,&nbsp;Kaavya Mandi ,&nbsp;Christina A. Raker ,&nbsp;Charles J. Milrod ,&nbsp;Ari R. Pelcovits","doi":"10.1016/j.jcpo.2025.100699","DOIUrl":"10.1016/j.jcpo.2025.100699","url":null,"abstract":"<div><h3>Introduction</h3><div>In clinical trials for diffuse large B-cell lymphoma (DLBCL), progression-free survival (PFS) has been used as a validated surrogate endpoint to help expedite drug development and regulatory approval. The advent of chimeric antigen receptor (CAR) T-cell therapies has radically changed the treatment landscape, potentially prolonging post-progression survival and weakening the correlation between PFS and overall survival (OS). This study evaluates the utility of PFS as a surrogate endpoint for OS in relapsed/refractory (R/R) DLBCL in the CAR T-cell era.</div></div><div><h3>Materials and methods</h3><div>A systematic review of Phase 3 randomized clinical trials for R/R DLBCL initiated after 2015 was conducted. A weighted linear regression analysis was performed to assess the correlation between PFS and OS.</div></div><div><h3>Results</h3><div>Six trials, comprising 1577 patients, met the inclusion criteria. Weighted linear regression demonstrated a coefficient of determination (R²) of 0.88 (p = 0.0054), indicating a strong association between PFS and OS in R/R DLBCL trials conducted since the introduction of CAR T-cell therapy.</div></div><div><h3>Discussion</h3><div>These findings provide evidence that PFS remains a valid and strong surrogate endpoint for OS in the contemporary R/R DLBCL treatment landscape. This supports the continued use of PFS as a primary endpoint in regulatory studies for new therapies for R/R DLBCL and provides important information for health policy discussions on drug approval, insurance coverage, and reimbursement decisions for aggressive lymphomas.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100699"},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811053","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}

{"title":"Innovative oncology trial designs: Time to act - A review with recommendations of the Cancer Drug Development Forum.","authors":"Rosa Giuliani, Nafsika Kronidou-Horst, Christina Yap, Aáron Sosa Mejia, Lada Leyens, Theodor Framke, Fergus Sweeney, Laurence Collette, Rachel Giles, Jan Bogaerts, Peter van de Ven, Stefan N Symeonides","doi":"10.1016/j.jcpo.2025.100696","DOIUrl":"10.1016/j.jcpo.2025.100696","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical oncology trial design constantly adapts and evolves to meet the needs of all stakeholders, from patients to regulators. This evolution has however also led to an increase in the complexity of clinical development, and investigators are expected to invest more time and money in planning and running their studies and overall clinical and regulatory pathway.</p><p><strong>Methods: </strong>Here we review recent innovations in trial designs, study endpoints, and relevant regulatory guidelines, before making recommendations to enhance the clinical trial ecosystem in the EU.</p><p><strong>Results: </strong>Innovative clinical study designs that go beyond traditional randomised, double-blinded, placebo-controlled trials often promise greater flexibility and efficiency in the conduct of oncology studies, but adoption has been slow. Furthermore, the increased complexity associated with innovative trials means that coordination between all relevant stakeholders is essential to every phase of clinical development. Despite recent advances, there is a risk that Europe is becoming seen as a less attractive location for clinical trials, and this article outlines initiatives and possible steps to improve patient access to medicines and processes across Europe.</p><p><strong>Policy summary: </strong>Innovative trial designs promise more efficient, flexible, and inclusive clinical trials, but more needs to be done to encourage their adoption if the advantages outweigh the limitations. Partnership and coordination between all stakeholders, from patients to regulators, and at all phases, is more important than ever. Finally, effective action is needed to make Europe a more attractive destination for clinical research and to improve access to innovative medicines for patients.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100696"},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805869","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}

{"title":"Economic burden of breast, cervical, and oral cancer in Bangladesh: a cost-of-illness study","authors":"Md. Ragaul Azim ,&nbsp;Quazi Nazmus Sakib ,&nbsp;Md. Mahfujur Rahman ,&nbsp;Md. Sirajul Islam ,&nbsp;Mushfika Binta Latif ,&nbsp;Md. Habibullah Talukder ,&nbsp;Syed Abdul Hamid","doi":"10.1016/j.jcpo.2025.100694","DOIUrl":"10.1016/j.jcpo.2025.100694","url":null,"abstract":"<div><h3>Background</h3><div>Breast, cervical, and oral cancers are leading causes of morbidity and mortality in Bangladesh, placing a heavy economic burden on households and the health system. Yet, this burden remains poorly understood, as no prior study has comprehensively examined their economic impact. Moreover, the profound psychological suffering experienced by patients are often overlooked in existing global evidence. Therefore, this study aims to estimate the comprehensive economic burden of breast, cervical, and oral cancers in Bangladesh from the household perspective.</div></div><div><h3>Methods</h3><div>Using a cross-sectional design, primary data were collected through structured interviews with 346 cancer patients. A cost-of-illness approach was employed. Direct medical and direct non-medical costs were estimated based on respondent-reported expenditures. Indirect costs, i.e.income loss, were calculated using the human capital approach. Intangible costs, reflecting pain and discomfort, were quantified using the willingness-to-pay method.</div></div><div><h3>Results</h3><div>The average total cost per patient was US$12,117, with breast cancer accounting for the highest burden. Intangible costs comprised 47.7 % of the total, underscoring the substantial psychological impact of cancer on patients. The combined national economic burden exceeded US$1.17 billion. Catastrophic health expenditure was nearly universal (99.1 %), with average treatment costs exceeding the catastrophic threshold by 44-fold. Expenditures were significantly higher among wealthier households, patients with longer disease duration, and those seeking care from multiple facilities.</div></div><div><h3>Conclusion</h3><div>Breast, cervical, and oral cancers impose a major financial and psychological burden on households in Bangladesh. The near-universal catastrophic health expenditure and high intangible costs highlight the urgent need for accessible and affordable cancer care.</div></div><div><h3>Policy summary</h3><div>Policies should strengthen financial protection, decentralize diagnosis and treatment, introduce insurance with cancer-specific benefits, establish an effective referral system, integrate psychosocial support and strengthen early detection programs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100694"},"PeriodicalIF":2.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800774","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}

{"title":"Interventions to improve cancer screening adherence in migrants and ethnic minorities in the European Region: A systematic review.","authors":"Chiara De Marchi ,&nbsp;Federica Di Lullo ,&nbsp;Caterina Ferrari ,&nbsp;Valentina Pettinicchio ,&nbsp;Alessandra Sinopoli ,&nbsp;Paolo lombardo ,&nbsp;Maria Elena Tosti ,&nbsp;Silvia Declich ,&nbsp;Scilla Pizzarelli ,&nbsp;Franca D’Angelo ,&nbsp;Maria Teresa Riccardi ,&nbsp;Fabiana Arrivi ,&nbsp;Francesca Maria Forestiero ,&nbsp;Virginia Rosca ,&nbsp;Alessandra Romano ,&nbsp;Daniela Marotta","doi":"10.1016/j.jcpo.2025.100677","DOIUrl":"10.1016/j.jcpo.2025.100677","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Policy Summary</h3><div>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.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100677"},"PeriodicalIF":2.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752305","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}

{"title":"The health and economic burden of lung cancer in Australia: A dynamic model of quality of life and productivity loss","authors":"Mohammad Afshar Ali ,&nbsp;Christine Y. Lu","doi":"10.1016/j.jcpo.2025.100674","DOIUrl":"10.1016/j.jcpo.2025.100674","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies estimated lung cancer costs; none examined quality of life and work productivity in Australia via population-based models.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100674"},"PeriodicalIF":2.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744733","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}

{"title":"Ensuring equitable access to cancer medicine and care in Australia: A human-rights lens, including people experiencing homelessness","authors":"Rashidul Alam Mahumud","doi":"10.1016/j.jcpo.2025.100678","DOIUrl":"10.1016/j.jcpo.2025.100678","url":null,"abstract":"<div><div>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.</div></div><div><h3>Objective</h3><div>To set out practical, rights-aligned actions that turn universal coverage into universal access.</div></div><div><h3>Approach</h3><div>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.</div></div><div><h3>Actionable implications</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100678"},"PeriodicalIF":2.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737669","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}