Division of Hematology-Oncology, Department of Medicine, Penn State Cancer Institute, Hershey, PA.
Department of Urology, University of Virginia, Charlottesville, VA.
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-14. doi: 10.1200/EDBK_350478.
Urothelial cancer care is particularly susceptible to geographical health disparity given its complex nature, requiring access to several specialists such as a urologist, a medical oncologist, a radiation oncologist, a surgical oncologist, and multidisciplinary care teams. Furthermore, other barriers to care access in underserved areas include travel burden, longer wait times, late-stage disease at the time of diagnosis, cost, type of treatment, less enrollment in clinical trials, lack of follow-up among cancer survivors, and less research funding in this area. Here, we discuss the impact of geographical location on access to urothelial cancer care, management decisions, and outcomes and we reflect on how to address geographical disparities in care delivery.
由于膀胱癌的复杂性，其治疗特别容易受到地域健康差异的影响，需要获得多位专家的治疗，如泌尿科医生、肿瘤内科医生、放射肿瘤学家、外科肿瘤学家和多学科护理团队。此外，服务不足地区获得护理的其他障碍包括旅行负担、更长的等待时间、诊断时的晚期疾病、成本、治疗类型、临床试验参与率较低、癌症幸存者缺乏随访以及该领域的研究资金较少。在这里，我们讨论了地理位置对膀胱癌治疗的可及性、管理决策和结果的影响，并反思了如何解决护理提供方面的地域差异。
