Sociedad Latino Americana y del Caribe de Oncologia Medica, Buenos Aires, Argentina.
Breast. 2010 Feb;19(1):50-4. doi: 10.1016/j.breast.2009.10.011. Epub 2009 Nov 28.
The BCRF II study presents a systematic review of the norms, recommendations and guidelines that are considered medical care standards (MCS) for breast cancer in 12 Latin American and Caribbean countries. Three key questions from the BCRF I survey data on early detection and diagnosis are presented to identify implementation practice patterns related to MCS.
Information related to MCS was requested from governmental health authorities, cancer institutes, and national scientific and professional societies in 12 Latin American and Caribbean countries. Documents received were reviewed by breast cancer experts from each respective country. Three key survey questions from the BCRF I survey on early detection and diagnosis were reprocessed to provide information related to implementation practice of existing MCS.
All countries included in the BCRF II study had medical care standards (MCS) whether published by governmental authorities, national professional or scientific associations, cancer institutes, or adoption of international MCS. Experts reported different practice patterns at a Country level versus a Center level. Overall, 85% of the experts reported that less than 50% of the women with no symptoms undergo a mammography at the Country level compared to 43% at the Center level. For diagnostic suspicion of breast cancer, 80% of experts considered the diagnostic suspicion at a Country level to come from the patient compared to 50% at a Center level. About 30% of patients waited for more than 3 months for a diagnosis at the Country level compared to 7% at the Center level.
All the Latin America and Caribbean countries in the study reported the use of similar MCS for breast cancer care. The reported difference between care practiced at a Country level versus a Center level suggests the challenge is not in generating new MCS, but in implementing policies and control mechanisms for compliance with existing MCS, guaranteeing their applicability to all populations.
BCRF II 研究对 12 个拉丁美洲和加勒比国家乳腺癌医疗保健标准 (MCS) 的规范、建议和指南进行了系统回顾。从 BCRF I 调查数据中提出了关于早期检测和诊断的三个关键问题，以确定与 MCS 相关的实施实践模式。
向 12 个拉丁美洲和加勒比国家的政府卫生当局、癌症研究所和国家科学与专业协会请求与 MCS 相关的信息。从每个国家收到的文件由来自各自国家的乳腺癌专家进行审查。对 BCRF I 调查中关于早期检测和诊断的三个关键调查问题进行了重新处理，以提供有关现有 MCS 实施实践的信息。
BCRF II 研究中包括的所有国家都制定了医疗保健标准 (MCS)，无论是由政府当局、国家专业或科学协会、癌症研究所发布的，还是采用国际 MCS。专家们报告了国家层面和中心层面的不同实践模式。总体而言，85%的专家报告称，没有症状的女性中不到 50%在国家层面接受乳房 X 光检查，而在中心层面这一比例为 43%。对于乳腺癌的诊断怀疑，80%的专家认为国家层面的诊断怀疑来自患者，而在中心层面这一比例为 50%。在国家层面，约 30%的患者等待诊断的时间超过 3 个月，而在中心层面这一比例为 7%。
研究中包括的所有拉丁美洲和加勒比国家都报告了使用类似的 MCS 进行乳腺癌护理。在国家层面与中心层面实践之间报告的差异表明，挑战不在于制定新的 MCS，而在于实施政策和控制机制以遵守现有 MCS，确保其适用于所有人群。
