Crown Angelena, Ramiah Kalpana, Siegel Bruce, Joseph Kathie-Ann
Breast Surgery, True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA.
America's Essential Hospitals, Washington, DC, USA.
Ann Surg Oncol. 2022 Mar 31. doi: 10.1245/s10434-022-11576-3.
Advances in breast cancer screening and systemic therapies have been credited with profound improvements in breast cancer outcomes; indeed, 5-year relative survival rate approaches 91% in the USA (U.S. National Institutes of Health NCI. SEER Training Modules, Breast). While breast cancer mortality has been declining, oncologic outcomes have not improved equally among all races and ethnicities. Many factors have been implicated in breast cancer disparities; chief among them is limited access to care which contributes to lower rates of timely screening mammography and, once diagnosed with breast cancer, lower rates of receipt of guideline concordant care (Wu, Lund, Kimmick GG et al. in J Clin Oncol 30(2):142-150, 2012). Hospitals with a safety-net mission, such as the essential hospitals, historically have been dedicated to providing high-quality care to all populations and have eagerly embraced the role of caring for the most vulnerable and working to eliminate health disparities. In this article, we review landmark articles that have evaluated the role safety-net hospitals have played in providing equitable breast cancer care including to those patients who face significant social and economic challenges.
乳腺癌筛查和全身治疗的进展被认为对乳腺癌治疗效果有显著改善；事实上，美国的5年相对生存率接近91%（美国国立卫生研究院国家癌症研究所。监测、流行病学和最终结果（SEER）培训模块，乳腺癌）。虽然乳腺癌死亡率一直在下降，但并非所有种族和族裔的肿瘤治疗效果都得到了同等程度的改善。许多因素与乳腺癌差异有关；其中最主要的是获得医疗服务的机会有限，这导致及时进行乳腺钼靶筛查的比率较低，而且一旦被诊断为乳腺癌，接受符合指南治疗的比率也较低（吴、伦德、金米克·G·G等人，《临床肿瘤学杂志》30(2):142 - 150，2012年）。具有安全网使命的医院，如基层医院，历来致力于为所有人群提供高质量的医疗服务，并积极承担起照顾最弱势群体和努力消除健康差距的责任。在本文中，我们回顾了一些具有里程碑意义的文章，这些文章评估了安全网医院在提供公平的乳腺癌护理方面所发挥的作用，包括为那些面临重大社会和经济挑战的患者提供护理。
