Otter Renée, Qiao You-Lin, Burton Robert, Samiei Massoud, Parkin Max, Trapido Edward, Weller David, Magrath Ian, Sutcliffe Simon
Comprehensive Cancer Centre North-East, PO Box 330, 9700 AH, Groningen, the Netherlands.
Tumori. 2009 Sep-Oct;95(5):623-36. doi: 10.1177/030089160909500505.
As cancer is to a large extent avoidable and treatable, a cancer control program should be able to reduce mortality and morbidity and improve the quality of life of cancer patients and their families. However, the extent to which the goals of a cancer control program can be achieved will depend on the resource constraints a country faces. Such population-based cancer control plans should prioritize effective interventions and programs that are beneficial to the largest part of the population, and should include activities devoted to prevention, screening and early detection, treatment, palliation and end-of-life care, and rehabilitation. In order to develop a successful cancer control program, leadership and the relevant stakeholders, including patient organizations, need to be identified early on in the process so that all partners can take ownership and responsibility for the program. Various tools have been developed to aid them in the planning and implementation process. However, countries developing a national cancer control program would benefit from a discussion of different models for planning and delivery of population-based cancer control in settings with differing levels of resource commitment, in order to determine how best to proceed given their current level of commitment, political engagement and resources. As the priority assigned to different components of cancer control will differ depending on available resources and the burden and pattern of cancer, it is important to consider the relative roles of prevention, early detection, diagnosis, treatment, rehabilitation and palliative care in a cancer control program, as well as how to align available resources to meet prioritized needs. Experiences from countries with differing levels of resources are presented and serve to illustrate the difficulties in developing and implementing cancer control programs, as well as the innovative strategies that are being used to maximize available resources and enhance the quality of care provided to cancer patients around the world.
由于癌症在很大程度上是可预防和可治疗的,癌症控制计划应能够降低死亡率和发病率,提高癌症患者及其家庭的生活质量。然而,癌症控制计划目标的实现程度将取决于一个国家所面临的资源限制。这种基于人群的癌症控制计划应优先考虑对最大部分人群有益的有效干预措施和项目,应包括致力于预防、筛查和早期检测、治疗、姑息治疗和临终关怀以及康复的活动。为了制定一个成功的癌症控制计划,在这个过程中需要尽早确定领导以及包括患者组织在内的相关利益攸关方,以便所有合作伙伴都能对该计划拥有所有权并承担责任。已经开发了各种工具来帮助他们进行规划和实施过程。然而,制定国家癌症控制计划的国家将受益于对不同资源投入水平环境下基于人群的癌症控制规划和实施的不同模式进行讨论,以便根据其当前的投入水平、政治参与度和资源情况确定最佳的推进方式。由于根据可用资源以及癌症负担和模式,分配给癌症控制不同组成部分的优先级会有所不同,因此重要的是要考虑预防、早期检测、诊断、治疗、康复和姑息治疗在癌症控制计划中的相对作用,以及如何调配可用资源以满足优先需求。本文介绍了不同资源水平国家的经验,这些经验有助于说明制定和实施癌症控制计划的困难,以及世界各地为最大限度利用可用资源和提高癌症患者护理质量而采用的创新策略。