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环北极因纽特人群的放射治疗可及性。

Access to radiotherapy among circumpolar Inuit populations.

机构信息

Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, ON, Canada; Department of Radiation Oncology, Amsterdam UMC Vrije University Medical Center, Amsterdam, Netherlands.

Department of Clinical Oncology, Rigshospitalet, Copenhagen, Denmark.

出版信息

Lancet Oncol. 2019 Oct;20(10):e590-e600. doi: 10.1016/S1470-2045(19)30394-8. Epub 2019 Sep 30.

Abstract

Cancer is a substantial health burden for Inuit populations, an Indigenous peoples who primarily inhabit the circumpolar regions of Alaska, Canada, Greenland, and Russia. Access to radiotherapy is lacking or absent in many of these regions, despite it being an essential component of cancer treatment. This Review presents an overview of factors influencing radiotherapy delivery in each of the four circumpolar Inuit regions, which include population and geography, health-systems infrastructure, and cancer epidemiology. This Review also provides insight into the complex patient pathways needed to access radiotherapy, and on radiotherapy use. The unique challenges in delivering radiotherapy to circumpolar Inuit populations are discussed, which, notably, include geographical and cultural barriers. Recommendations include models of care that have successfully addressed these barriers, and highlight the need for increased collaboration between circumpolar referral centres in Alaska, Canada, Greenland, and Russia to ultimately allow for better delivery of cancer treatment.

摘要

癌症是因纽特人群体的一个重大健康负担,因纽特人是主要居住在环北极地区的原住民,包括阿拉斯加、加拿大、格陵兰和俄罗斯。尽管放疗是癌症治疗的重要组成部分,但在这些地区的许多地方,放疗的可及性或不存在。本综述介绍了影响四个环北极因纽特地区放疗实施的因素,包括人口和地理、卫生系统基础设施以及癌症流行病学。本综述还深入探讨了获得放疗所需的复杂患者途径,以及放疗的使用情况。讨论了向环北极因纽特人群提供放疗所面临的独特挑战,其中包括地理和文化障碍。建议包括成功解决这些障碍的护理模式,并强调需要增加阿拉斯加、加拿大、格陵兰和俄罗斯之间的环北极转诊中心之间的合作,最终实现更好的癌症治疗。

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