Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of California San Diego/Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, CA.
Population Sciences, Disparities and Community Engagement, University of California San Diego Moores Cancer Center, La Jolla, CA.
Am Soc Clin Oncol Educ Book. 2021 Jun;41:e315-e326. doi: 10.1200/EDBK_320499.
Adult cancer disparities have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Pediatric cancer survival has improved significantly in the United States for the past 5 decades to over 80%; however, disparate outcomes among children and adolescents with cancer still affect many populations in the United States and globally, including racial and ethnic minorities, populations with low socioeconomic status, and residents of underserved areas. To achieve equitable outcomes for all children and adolescents with cancer, it is imperative that concerted multilevel approaches be carried out to understand and address health disparities and to ensure access to high-quality cancer care. Addressing social determinants of health, such as removing barriers to health care access and ensuring access to social supports, can reduce pediatric cancer disparities. Nevertheless, public health policy, health system interventions, and innovative delivery of evidence-based services are critically needed. Partnerships among patients, caregivers, and health care providers, and among health care, academic, and governmental institutions, have a pivotal role in reducing cancer disparities and improving outcomes in the 21st century.
几十年来，成人癌症的差异一直存在，尽管癌症预防、检测和治疗方面取得了临床进展，但这种差异仍在持续。在过去的 50 年中，美国儿童癌症的存活率显著提高，超过了 80%；然而，癌症患儿和青少年之间的不同结局仍然影响着美国和全球的许多人群，包括少数族裔和少数民族、社会经济地位低的人群以及服务不足地区的居民。为了实现所有癌症患儿和青少年的公平结果，必须采取协调一致的多层次方法来理解和解决健康差异问题，并确保获得高质量的癌症护理。解决健康的社会决定因素，例如消除获得医疗保健的障碍并确保获得社会支持，可以减少儿科癌症的差异。然而，迫切需要公共卫生政策、卫生系统干预措施以及创新的循证服务提供。患者、护理人员和医疗保健提供者之间，以及医疗保健、学术和政府机构之间的伙伴关系，在减少癌症差异和改善 21 世纪的结果方面发挥着关键作用。
