Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Union for International Cancer Control, Geneva, Switzerland.
Int J Cancer. 2021 Apr 15;148(8):1938-1947. doi: 10.1002/ijc.33384. Epub 2020 Nov 17.
In order to understand the structure and effectiveness of national cancer control systems, the International Cancer Control Partnership, the World Health Organization, the National Cancer Institute and the Union for International Cancer Control underwent a review of available national cancer health plans (NCCPs) and noncommunicable diseases plans (NCDPs) worldwide. Pathology and Laboratory Medicine (PALM) plays a major role in cancer management, from prevention and screening to patient care (diagnosis and treatment) and population-level cancer surveillance. This review concentrates on the analysis of elements in national cancer care plans pertaining to PALM. Of 157 countries surveyed, 90 (57%) had a NCCP and 123 (78%) had a NCDP. While 54% of plans included guidelines on cancer diagnosis or plans to develop standards protocols for diagnosis, only 14% included PALM as a component of the plan. PALM-related variables such as synoptic pathology reporting, cancer staging guidelines and cancer genetics programs were similarly underrepresented (being mentioned in only 6%, 17% and 16% of plans, respectively). Absence of PALM-related variables tended to be more frequent in lower-income countries. Our analysis highlights an important gap in national cancer control initiatives worldwide represented by the overall lack of inclusion of PALM resources. Cancer control will only be effective if laboratory sciences are placed as a priority. Based on the data presented herein, there is a need to increase awareness about the importance of PALM in cancer care, and to incorporate this discipline in the design and implementation of multilevel cancer control strategies.
为了了解国家癌症控制系统的结构和效果，国际癌症控制伙伴关系、世界卫生组织、美国国家癌症研究所和国际抗癌联盟对全球现有的国家癌症卫生计划（NCCP）和非传染性疾病计划（NCDP）进行了审查。病理学和实验室医学（PALM）在癌症管理中起着重要作用，从预防和筛查到患者护理（诊断和治疗）以及人群层面的癌症监测。本次审查重点分析了与 PALM 相关的国家癌症护理计划中的要素。在所调查的 157 个国家中，有 90 个（57%）制定了国家癌症控制计划，有 123 个（78%）制定了非传染性疾病计划。虽然 54%的计划包含了癌症诊断指南或制定诊断标准协议的计划，但只有 14%的计划将 PALM 作为计划的一部分。PALM 相关的变量，如综合病理报告、癌症分期指南和癌症遗传学计划的代表性也很低（分别在 6%、17%和 16%的计划中提及）。缺乏与 PALM 相关的变量在低收入国家更为常见。我们的分析强调了全球国家癌症控制倡议中存在的一个重要差距，即总体上缺乏纳入 PALM 资源。如果实验室科学被置于优先地位，癌症控制才会有效。基于本文提供的数据，需要提高人们对 PALM 在癌症护理中的重要性的认识，并将这一学科纳入多层次癌症控制策略的设计和实施中。
