Al-Sukhun Sana, de Lima Lopes Gilberto, Gospodarowicz Mary, Ginsburg Ophira, Yu Peter Paul
From the Al-Hayat Medical Center, Amman, Jordan; Sylvester Comprehensive Cancer Center and Miller School of Medicine, University of Miami, Miami, FL; University of Toronto, Cancer Care Ontario, Princess Margaret Cancer Centre, and University Health Network, Toronto, Canada; Laura and Isaac Perlmutter Cancer Center at NYU Langone Medical Center, New York, NY; Hartford Healthcare, Hartford, CT.
Am Soc Clin Oncol Educ Book. 2017;37:395-402. doi: 10.1200/EDBK_100008.
Cancer has become one of the leading causes of morbidity and mortality in low- and middle-income countries (LMICs), where 60% of the world's total new cases are diagnosed. The challenge for effective control of cancer is multifaceted. It mandates integration of effective cancer prevention, encouraging early detection, and utilization of resource-adapted therapeutic and supportive interventions. In the resource-constrained setting, it becomes challenging to deliver each service optimally, and efficient allocation of resources is the best way to improve the outcome. This concept was translated into action through development of resource-stratified guidelines, pioneered by the Breast Health Global Initiative (BHGI), and later adopted by most oncology societies in an attempt to help physicians deliver the best possible care in a limited-resource setting. Improving outcome entails collaboration between key stakeholders, including the pharmaceutical industry, local and national health authorities, the World Health Organization (WHO), and other nonprofit, patient-oriented organizations. Therefore, we started to observe global health initiatives-led by ASCO, the Union for International Cancer Control (UICC), and the WHO-to address these challenges at the international level. This article discusses some of these initiatives.
癌症已成为低收入和中等收入国家(LMICs)发病和死亡的主要原因之一,全球60%的新增病例在这些国家被诊断出来。有效控制癌症面临多方面挑战。它要求整合有效的癌症预防措施、鼓励早期检测,并采用适应资源状况的治疗和支持性干预措施。在资源有限的情况下,要最佳地提供每项服务具有挑战性,而有效分配资源是改善结果的最佳途径。这一理念通过制定资源分层指南转化为行动,该指南由全球乳腺癌倡议(BHGI)首创,后来被大多肿瘤学会采用,旨在帮助医生在资源有限的环境中提供尽可能好的治疗。改善结果需要关键利益相关者之间的合作,包括制药行业、地方和国家卫生当局、世界卫生组织(WHO)以及其他非营利性、以患者为导向的组织。因此,我们开始看到由美国临床肿瘤学会(ASCO)、国际癌症控制联盟(UICC)和世界卫生组织主导的全球卫生倡议——在国际层面应对这些挑战。本文讨论其中一些倡议。