Abdel-Razeq Hikmat, Mansour Asem, Jaddan Dima
Department of Internal Medicine, Section of Hematology and Medical Oncology, King Hussein Cancer Center, Amman, Jordan.
School of Medicine, University of Jordan, Amman, Jordan.
JCO Glob Oncol. 2020 Feb;6:260-268. doi: 10.1200/JGO.19.00279.
Breast cancer is the most common malignancy in Jordan and the third leading cause of cancer death after lung and colorectal cancers. Although the incidence of breast cancer in Jordan is lower than that in industrialized nations, the number of new cases has been significantly increasing, and women present with breast cancer at a younger age and with more advanced disease than women in Western countries. Jordan is a medium-income country with limited resources and a young population structure. Therefore, breast cancer poses a particularly challenging burden on the country's health care system. Despite ongoing endeavors to improve breast cancer care at both public and private levels, more work is needed to achieve downstaging of the disease and improve access, awareness, and participation in early detection. Multimodality treatment facilities and supportive care are available; however, the quality of care varies widely according to where the patient is treated, and most treatment facilities remain located centrally, thus, creating access difficulties. The King Hussein Cancer Center, the only comprehensive cancer center in Jordan, has changed the practice of oncology in the country via implementation of a multidisciplinary approach to treatment, monitoring of treatment outcomes, and investments in ongoing cancer research. However, there remains no national system for ensuring provision of high-quality cancer care nationwide. Here, we review the epidemiology of breast cancer and the current status of breast cancer care in Jordan, we compare our treatment outcomes with international ones, and we highlight challenges and improvement opportunities.
乳腺癌是约旦最常见的恶性肿瘤,是继肺癌和结直肠癌之后癌症死亡的第三大主要原因。尽管约旦的乳腺癌发病率低于工业化国家,但新发病例数量一直在显著增加,而且与西方国家的女性相比,约旦女性患乳腺癌时年龄更小,疾病更晚期。约旦是一个中等收入国家,资源有限,人口结构年轻。因此,乳腺癌给该国的医疗保健系统带来了特别具有挑战性的负担。尽管公私部门都在不断努力改善乳腺癌护理,但仍需要开展更多工作,以实现疾病降期,并改善疾病的发现、提高意识以及促进早期检测的参与度。多模式治疗设施和支持性护理是可用的;然而,护理质量因患者接受治疗的地点而异,而且大多数治疗设施仍集中在中心地区,因此造成了就医困难。侯赛因国王癌症中心是约旦唯一的综合癌症中心,通过实施多学科治疗方法、监测治疗结果以及对正在进行的癌症研究进行投资,改变了该国的肿瘤学治疗实践。然而,约旦仍然没有一个全国性系统来确保在全国范围内提供高质量的癌症护理。在此,我们回顾了约旦乳腺癌的流行病学情况和乳腺癌护理的现状,将我们的治疗结果与国际结果进行了比较,并强调了挑战和改进机会。