Journal of Cancer Policy最新文献

{"title":"Exploring experiences of reasonable adjustments in cancer care among patients with disabilities and their carers: A focus group study in South West England","authors":"Selin Siviş ,&nbsp;Andrew Turner ,&nbsp;Hannah Little ,&nbsp;Shamim Kholwadia ,&nbsp;Ruth Hendy ,&nbsp;Fiona Spence ,&nbsp;Gifty Markey ,&nbsp;Jon Banks","doi":"10.1016/j.jcpo.2025.100641","DOIUrl":"10.1016/j.jcpo.2025.100641","url":null,"abstract":"<div><h3>Background</h3><div>The UK Equality Act 2010 mandates equal access to healthcare for people with disabilities. For those with disabilities who have also been diagnosed with cancer, addressing these needs is complex and multifaceted. Whilst existing research has primarily focused on reasonable adjustments for individuals with learning disabilities or autism, this study broadens the scope to include physical disabilities, cognitive or sensory impairments, and mental health conditions.</div></div><div><h3>Aim</h3><div>This study aimed qualitatively explore and understand the experiences of individuals with disabilities requiring reasonable adjustments, who have direct or indirect exposure to cancer treatment within the cancer care setting, as well as the experiences of their carers.</div></div><div><h3>Methods</h3><div>Qualitative study based on seven focus groups with 44 participants who have direct or indirect experience of cancer treatment and experience of one or more of a range of conditions that may require reasonable adjustments. Thematic analysis was used inductively to explore patterns.</div></div><div><h3>Results</h3><div>Participants described various care pathway adjustments but also noted their limited effectiveness. The main concern was a lack of alignment with individual needs. Three key areas for improvement emerged: (1) communication and coordination (e.g., clearer signposting, longer appointments, better understanding of needs); (2) support for family and carers (e.g., tailored adjustments for caregivers, clearer explanations); and (3) adherence to compassion and empathy (e.g., avoiding jargon, using accessible language, and ensuring patients feel heard).</div></div><div><h3>Conclusion</h3><div>Reasonable adjustments are necessary but not sufficient for equitable care. Participants emphasised the need for an integrated approach to individual needs to ensure adjustments are both accessible and effective.</div></div><div><h3>Policy summary</h3><div>An integrated understanding of individuals’ and their family carers’ needs should underpin approaches to reasonable adjustments by healthcare providers. A first step to achieving this is to develop training for healthcare professionals to encompass a broader understanding of reasonable adjustments beyond legal categories.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100641"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103086","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":"A comparison of the cost-effectiveness of HPV (self-sampling and health care provider sampling) versus VIA for cervical cancer screening in India","authors":"Apourv Pant,&nbsp;Gowthaman Thangavel,&nbsp;Stany Mathew,&nbsp;Anita Nath","doi":"10.1016/j.jcpo.2025.100642","DOIUrl":"10.1016/j.jcpo.2025.100642","url":null,"abstract":"<div><div>Cervical cancer ranks as the fourth most common cancer in women globally and the second most prevalent in India. Preventive measures, such as HPV vaccination and various screening methods, are essential. Despite these strategies, the economic burden of cervical cancer remains significant due to its long-term nature and treatment costs. This study evaluates the cost-effectiveness of three screening approaches—VIA, HPV physician sampling, and HPV self-sampling—for women aged 30–65. A Markov-based cost-utility analysis with a lifetime horizon and one-year cycle length was conducted. Model parameters were sourced from peer-reviewed literature, national cancer registries, and health economic studies. Deterministic and probabilistic sensitivity analyses were performed to ensure the robustness of the results. Health Provider HPV sampling yielded the highest Quality-Adjusted Life Years (QALYs) at 5.97 (three years) and 4.28 (five years), compared to VIA’s 4.01 (three years) and 2.9 (five years), and HPV self-sampling’s 4.71 (three years) and 3.41 (five years). Over 30 cycles for 100,000 women, healthcare provider sampling achieved a maximum QALY gain of 13.40. Compared to other methods, it offered a gain of 2.94 QALYs at an incremental cost of 19,409 INR. While VIA screening is cost-saving, it provides reduced health benefits. HPV healthcare provider sampling is more cost-effective in terms of QALYs gained despite higher screening costs. A policy analysis is necessary to achieve 70 % cervical cancer screening coverage in India, focusing on current HPV screening strategies and identifying areas for improvement.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100642"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103065","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":"Psycho-oncology in India","authors":"J. Deodhar ,&nbsp;P. Nayak ,&nbsp;C.S. Pramesh ,&nbsp;A. Purushotham","doi":"10.1016/j.jcpo.2025.100640","DOIUrl":"10.1016/j.jcpo.2025.100640","url":null,"abstract":"<div><div>Psychosocial care is essential for high-quality cancer care. Psycho-oncology is a developing discipline globally. A narrative review was conducted of studies published in India from 2000 to 2024 on psychosocial care in patients with cancer. Of 233 papers identified, 85 were included. Distress rates ranged from 22 % to 62 % with the highest being in head and neck and breast cancer. Seven tools for measuring distress have been validated in a few Indian languages. Cancer-related communication revealed high rates of collusion and use of euphemisms. There is a paucity of intervention studies. Few studies described psychosocial issues in children and adolescents and older adults.Therefore, future high-quality intervention and outcome studies are required. There is an urgent need for the inclusion of psycho-oncology in national cancer control policy globally.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100640"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087645","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":"Therapeutic value of oncology drugs approved by Health Canada through Project Orbis: a cross-sectional study","authors":"Joel Lexchin","doi":"10.1016/j.jcpo.2025.100635","DOIUrl":"10.1016/j.jcpo.2025.100635","url":null,"abstract":"<div><h3>Background</h3><div>In May 2019, the US Food and Drug Administration (FDA) initiated Project Orbis with the aim of providing patients faster access to promising cancer treatments by promoting coordination with international regulatory agencies, including Health Canada. This study evaluates the additional therapeutic value of drugs approved by Health Canada through Project Orbis.</div></div><div><h3>Methods</h3><div>The FDA list of drugs approved through Project Orbis until the end of 2024 was downloaded and drugs that Health Canada participated in were identified. The type of approval that Health Canada gave these drugs – standard, priority and Notice of Compliance with conditions (NOC/c, conditional approval) was identified. The additional therapeutic value of the drugs (major, moderate and minor) was assessed from the ratings of four international organizations. The distribution of additional therapeutic value (minor, moderate, major) according to review type was compared using a Chi-square test.</div></div><div><h3>Results</h3><div>The FDA approved 68 drugs for 112 indications of which 49 (72.1 %) drugs were reviewed by Health Canada for 78 (69.6 %) indications (30 new drugs and 48 new indications for existing drugs). The manufacturer withdrew one drug from the approval process leaving 77 new drugs and new indications for analysis. Twenty-eight drugs had a standard review, 31 a priority review and 18 a NOC/c review. The distribution of additional therapeutic value by review type was statistically significantly different, p = 0.0052 (Chi-square test). Sixteen (69.6 %) out of 23 drugs with a priority review offered either moderate (10) or major (6) additional therapeutic gains. Only 12 of the remaining 40 drugs with a therapeutic evaluation that had other types of approval had moderate or major additional therapeutic value.</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that Health Canada’s participation in Project Orbis should concentrate on drugs that qualify for a priority review.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100635"},"PeriodicalIF":2.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893481","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":"Assessing and comparing patient engagement in clinical cancer research: A cross-regional analysis between Europe and Japan using a structured evaluation tool","authors":"Laureline Gatellier ,&nbsp;Beatrice Serckx ,&nbsp;Lode Dewulf ,&nbsp;Nicholas Brooke ,&nbsp;Bertrand Tombal ,&nbsp;Hadrien Charvat ,&nbsp;Keiko Katsui ,&nbsp;Yoshiyuki Majima ,&nbsp;Jin Higashijima ,&nbsp;Kazuyuki Suzuki ,&nbsp;Ingrid Klingmann ,&nbsp;Beata Juzyna ,&nbsp;Iryna Shakhnenko ,&nbsp;Kenichi Nakamura ,&nbsp;Tomohiro Matsuda","doi":"10.1016/j.jcpo.2025.100634","DOIUrl":"10.1016/j.jcpo.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Meaningful patient engagement (PE) is increasingly recognized as a critical element of clinical cancer research. Policy frameworks in Europe and Japan reflect growing support for involving patients in research and policymaking. However, tools to assess the actual implementation of PE in clinical trials remain limited. This study introduces a structured, self-evaluation tool for principal investigators (PIs) to assess PE and compares its application to academic trials across Europe and Japan.</div></div><div><h3>Methods</h3><div>A two-dimensional matrix was developed to evaluate PE across eight key research steps—research priorities, fundraising, protocol development, informed consent, ethical review, investigator meetings, reporting, and regulatory submission—against five engagement levels (0: none to 4: co-creation). The tool was refined to ensure linguistic and contextual applicability in both regions. A structured questionnaire incorporating the matrix was distributed to PIs identified from public databases. Statistical analyses were conducted to compare PE practices between both regions.</div></div><div><h3>Results</h3><div>Among 178 European and 123 Japanese trials, PI response rate were 24.2 % (n = 43) and 52.0 % (n = 64), respectively. Across all research steps, 60.7 % of European and 80.6 % of Japan trials contained no PE. However, PE was reported in at least one step in 86.0 % of European and 39.1 % of Japanese trials. When engaging, European trials showed higher levels in protocol development, informed consent, ethical review, and reporting steps than Japan (<em>p</em> &lt; 0.001 for all).</div></div><div><h3>Conclusion</h3><div>This study developed a simple, structured tool to assess PE and applied it to trials in Europe and Japan. It revealed regional differences across culturally and structurally distinct systems, demonstrating its value for cross-context comparison and broader application.</div></div><div><h3>Policy summary</h3><div>By enabling structured assessment and monitoring of PE, this tool supports the implementation of engagement policies across regions. Its adaptability may foster shared learning and cross-border collaboration, especially in regions where engagement frameworks are still emerging.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100634"},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912721","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":"Financial burden due to distance traveled to access treatment from specialized cancer hospitals in public sector in India: a case study of patients treated for gastric and pancreatic cancer","authors":"Mohit Pandey ,&nbsp;T.R. Dilip ,&nbsp;Amit Chopade ,&nbsp;Shailesh V. Shrikhande ,&nbsp;Manish Bhandare","doi":"10.1016/j.jcpo.2025.100632","DOIUrl":"10.1016/j.jcpo.2025.100632","url":null,"abstract":"<div><h3>Background</h3><div>Cancer care offered in India and large part of the world is heterogenous with few regions having dedicated high volume centres with established referral patterns. Due to scarcity of the specialized units treating cancer, patients often have to travel for long distances for medical care. Our study examines the impact of additional financial burden (non-medical expenses) on cancer patients’ families due to long distance travelled while seeking treatment for gastric and pancreatic cancer.</div></div><div><h3>Methods</h3><div>The data (n = 244) were collected as part of a prospective, non-interventional cohort study, conducted at Tata Memorial Hospital (TMH), Mumbai, India. Consecutive patients with gastric and pancreatic cancers. The medical and non-medical expenditures were collected for each visit along with other cancer specific and treatment details. Distress financing defined as borrowing money or selling assets to meet treatment-related expenses.</div></div><div><h3>Findings</h3><div>The mean distance travelled by patients was 1475 km. 63.1 % of patients travelled greater than 1500 km. The mean Non-Medical Health Expenditure (NMHE) for patients traveling more than 1500 km was ₹107,040 ($1278), nearly two times higher than the expenditure for patients traveling less than 500 km, ₹49,112 ($587). A total of 42.9 % of NMHE was spent on travel, 33.3 % on accommodation, and 17.2 % on food. The logistic regression results depict that patients traveling &gt; 500 km are three times more likely to experience Catastrophic NMHE (CNMHE) compared to &lt; 500 km. The distress health financing due to cancer treatment was 39.3 %. Distress health financing was higher with CNMHE at 25 % (52.8 %) compared to CNMHE at 10 % (45.8 %), and was two times higher in patients travelling &gt; 500 km compared to &lt; 500 km</div></div><div><h3>Conclusion</h3><div>A structured decentralization of cancer care is the need of the hour to negate the additional financial burden and CNMHE experienced by the cancer patients and their families. If adequate infrastructure is provided at the non-urban areas, well trained oncologists can be deployed in hospitals closer to patients homes to treat cancers at earlier stage.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100632"},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865215","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":"Navigating cost and care: A qualitative study on oncologists’ perspectives on financial toxicity in India","authors":"Parth Sharma ,&nbsp;Bhavna Seth ,&nbsp;Vid Karmarkar ,&nbsp;Pooja Sharma","doi":"10.1016/j.jcpo.2025.100633","DOIUrl":"10.1016/j.jcpo.2025.100633","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore oncologists’ perspectives on how financial toxicity (FT) shapes clinical decision-making and to identify potential solutions to reduce its impact.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study using semi-structured interviews with nineteen oncologists working across public, private, and not-for-profit hospitals in nine Indian states. The interviews were audio-recorded, transcribed, and analyzed till thematic analysis until data saturation was achieved.</div></div><div><h3>Results</h3><div>The oncologists reported that FT impacted their decision making in four ways:1) Tailoring treatment discussions, 2) Diagnostic adaptations, e.g. avoiding expensive diagnostic tests, 3) Treatment modification, e.g. using treatment protocols based on local research or using generic drugs, and 4) Referral of patients to government centers from private centers. Financial status was assessed by an assessment committee, administrator, clinician, nurse, or social worker. Understanding methods of distress financing, checking eligibility for treatment schemes, and assessing socioeconomic status, expenditure capacity, and insurance coverage were some of the methods used for the financial assessment of patients. Participants suggested improvements at 1) Health system level - expanding public insurance, regulating private hospital pricing, strengthening district-level cancer care, and improving the availability of affordable generic medications, 2) Hospital-level - establishing patient assistance programs, financial navigation services, grievance redressal systems, and multidisciplinary tumor boards to guide evidence-based, cost-conscious care and 3) Provider level - clear, empathetic shared-decision making communication, thoughtful clinical judgment, early palliative care integration, and engaging with policymakers to advocate for broader reforms.</div></div><div><h3>Conclusion</h3><div>Oncologists in India routinely adapt to account for patients’ financial limitations. Addressing financial toxicity requires coordinated interventions at the system, hospital, and provider levels to ensure equitable, affordable access to cancer care.</div></div><div><h3>Policy summary</h3><div>This paper highlights the need for a comprehensive National Cancer Policy in India and the need to expand coverage of the government-funded health insurance schemes.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100633"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827124","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":"Barriers and enablers of research engagement among multidisciplinary cancer care professionals in Ireland: A mixed-methods study","authors":"Amanda Drury ,&nbsp;Christopher Crockford","doi":"10.1016/j.jcpo.2025.100630","DOIUrl":"10.1016/j.jcpo.2025.100630","url":null,"abstract":"<div><h3>Rationale</h3><div>Nurses and health and social care professionals (HSCPs) are integral to multidisciplinary cancer care and are well-positioned to engage in research that enhances patient outcomes. However, unlike medical professionals, non-medical clinicians often face substantial barriers to research engagement, including limited institutional support, time constraints, and lack of research training and mentorship.</div></div><div><h3>Aim</h3><div>To explore the barriers and enablers to research activity among nurses and HSCPs working in clinical cancer care settings in Ireland.</div></div><div><h3>Methods</h3><div>A mixed methods design was used. Phase 1 consisted of a stakeholder consultation workshop (n = 14) to qualitatively identify research barriers and enablers. Phase 2 involved a cross-sectional questionnaire (n = 157) assessing participants’ research capacity, activity, and influencing factors using the Research Capacity and Culture (RCC) tool and additional study-specific items.</div></div><div><h3>Results</h3><div>Key barriers identified included lack of protected research time (64.3 %), funding (65.0 %) and resourcing/support (64.3 %). Participants reported moderate individual research skills, particularly in literature review and data collection, but lower confidence in research leadership activities, including grant writing, budgeting, and protocol development. Despite barriers, 73.9 % of participants expressed interest in research activities, especially in data collection, analysis, and project leadership. Access to academic-clinical partnerships, supportive management, and training opportunities were cited as critical enablers.</div></div><div><h3>Conclusions</h3><div>There is significant untapped potential for research engagement among non-medical cancer care professionals in Ireland. Organizational investment in protected research time, mentorship, and targeted training is essential to build research capacity, support clinician-led research, and improve outcomes for patients and healthcare systems alike.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100630"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812545","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":"Direct and indirect costs of breast cancer management in Sub-Saharan Africa","authors":"Irénée Ahindu Konga ,&nbsp;Vanina Pofagi ,&nbsp;Alexis Parenté ,&nbsp;Freddy Gnangnon ,&nbsp;Dismand Houinato ,&nbsp;Clémence Thébaut","doi":"10.1016/j.jcpo.2025.100629","DOIUrl":"10.1016/j.jcpo.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>In Benin, breast cancer is the leading cause of cancer-related mortality among women, with 566 deaths reported in 2020. The cost of its management remains poorly understood, although its estimation is essential for assessing the implementation of public health policies, particularly in a resource-limited setting. This study aims to estimate the direct and indirect costs of breast cancer management from the patients' perspective.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in three healthcare facilities in Cotonou, collecting healthcare expenditures from 104 breast cancer patients through a structured questionnaire. A linear regression analysis was performed to identify factors influencing direct medical costs.</div></div><div><h3>Results</h3><div>The average direct medical cost of breast cancer management in Benin was estimated at US$ 4768.3 (± US$ 774.7). The median productivity loss cost, based on patient-reported data, was US$ 954.4 (IQR = US$ 477.2 – US$ 1336.1). Chemotherapy accounted for 38.5 % of the direct medical costs. An advanced disease stage was significantly associated with higher medical costs (coefficient = 0.50; p = 0.007).</div></div><div><h3>Conclusion</h3><div>Breast cancer leads to high direct and indirect costs, especially in the advanced stages of the disease in Sub-Saharan Africa. These findings highlight the need for the implementation of early screening programs to reduce costs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100629"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769177","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":"Long-term quality of life and quality adjusted life years after breast cancer: Impact of detection mode, tumor characteristics and treatment","authors":"Nataliia Moshina ,&nbsp;Ragnhild S. Falk ,&nbsp;Edoardo Botteri ,&nbsp;Marthe Larsen ,&nbsp;Lars A. Akslen ,&nbsp;Giske Ursin ,&nbsp;John A. Cairns ,&nbsp;Solveig Hofvind","doi":"10.1016/j.jcpo.2025.100631","DOIUrl":"10.1016/j.jcpo.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) of breast cancer survivors has been extensively evaluated. However, HRQoL differences for women diagnosed by organized mammographic screening and women diagnosed due to symptoms have been sparsely described. We aimed to compare self-reported long-term HRQoL and quality adjusted life years (QALYs) between women with screen-detected breast cancer and women with symptomatic breast cancer, adjusting for histopathologic tumor characteristics and treatment.</div></div><div><h3>Methods</h3><div>This study was nested within a cohort of women diagnosed with breast cancer by organized mammographic screening or due to symptoms 2006–2017 who responded a questionnaire measuring HRQoL (VAS, 0–100) and EQ-5D-5L 2019–2020. Responses to EQ-5D-5L were transformed into health utility values using a tariff based on preferences elicited in a national survey. Multivariable linear regression models were used to compare VAS-scores adjusting for tumor characteristics and treatment. QALYs were estimated by summing up the health utility values between the third and the fifth year since breast cancer diagnosis adjusting for breast cancer survival.</div></div><div><h3>Results</h3><div>Mean HRQoL (VAS) was 66.2 (standard deviation, SD: 21.1) for women with screen-detected breast cancer (n = 1141) and 62.5 (SD: 21.2) for women with symptomatic breast cancer (n = 1561). Women with screen-detected breast cancer had 3.8 (95 % confidence interval, CI, 2.3, 5.4) and 3.7 (95 %CI 2.1, 5.2) higher HRQoL VAS-scores compared to women with symptomatic breast cancer in the models adjusted for tumor characteristics and treatment, respectively. Women with screen-detected breast cancer and women with symptomatic breast cancer accrued 2.30 and 2.06 QALYs, respectively.</div></div><div><h3>Conclusion</h3><div>Women with screen-detected breast cancer demonstrated higher estimates of long-term HRQoL and QALYs compared to women with symptomatic cancer.</div></div><div><h3>Policy Summary</h3><div>More favorable long-term quality of life outcomes were shown for women diagnosed with breast cancer by organized mammographic screening compared to women diagnosed due to symptoms.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100631"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800570","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}