Dickerson James C, Ragavan Meera V, Parikh Divya A, Patel Manali I
Department of Internal Medicine, Stanford University, Stanford, CA 94305, United States.
Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305, United States.
World J Clin Oncol. 2020 Sep 24;11(9):705-722. doi: 10.5306/wjco.v11.i9.705.
Globally, cancer care delivery is marked by inequalities, where some , and groups have worse outcomes than others. In this review, we sought to identify patient-facing interventions designed to reduce disparities in cancer care in both high- and low-income countries. We found two broad categories of interventions that have been studied in the current literature: Patient navigation and telehealth. Navigation has the strongest evidence base for reducing disparities, primarily in cancer screening. Improved outcomes with navigation interventions have been seen in both high- and low-income countries. Telehealth interventions remain an active area of exploration, primarily in high income countries, with the best evidence being for the remote delivery of palliative care. Ongoing research is needed to identify the most efficacious, cost-effective, and scalable interventions to reduce barriers to the receipt of cancer care globally.
在全球范围内,癌症护理服务存在不平等现象,一些群体和社区的治疗结果比其他群体更差。在本综述中,我们试图确定旨在减少高收入和低收入国家癌症护理差距的面向患者的干预措施。我们发现当前文献中研究的两大类干预措施:患者导航和远程医疗。导航在减少差距方面有最有力的证据基础,主要体现在癌症筛查方面。在高收入和低收入国家,导航干预措施都取得了更好的治疗结果。远程医疗干预措施仍是一个活跃的探索领域,主要在高收入国家,最有力的证据是姑息治疗的远程提供。需要进行持续研究,以确定最有效、最具成本效益和可扩展的干预措施,以减少全球范围内接受癌症护理的障碍。