Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
Lancet Oncol. 2022 May;23(5):e209-e217. doi: 10.1016/S1470-2045(22)00057-2.
Many social determinants that are outside an individual's control affect their exposure to cancer risk factors and access to high-quality care. There is increasing recognition that national cancer control plans are fundamental tools to address cancer burden and promote equitable care. To investigate how policies in the WHO region of the Americas promote equity in cancer care, we evaluated 46 cancer-related health plans covering 34 countries. We analysed and coded the text of the documents according to 40 indicators and three dimensions (context, equity, and governance). Our results suggest that equity is not sufficiently integrated in national cancer control plans in the region. 17 documents defined inequity as a problem mainly related to difficulties in the access to care. Although 25 countries had designed equitable interventions, none had dedicated a budget for their implementation. Countries still need to translate their expressed concern with equity in health into funded, targeted interventions that accompany patients throughout the entire cancer care continuum.
许多个人无法控制的社会决定因素会影响他们接触癌症风险因素的机会和获得高质量医疗的机会。越来越多的人认识到，国家癌症控制计划是应对癌症负担和促进公平护理的基本工具。为了调查美洲世卫组织区域的政策如何促进癌症护理的公平性，我们评估了涵盖 34 个国家的 46 项与癌症相关的卫生计划。我们根据 40 项指标和三个维度（背景、公平性和治理）对文件的文本进行了分析和编码。我们的研究结果表明，该地区的国家癌症控制计划没有充分纳入公平性。17 份文件将不平等定义为主要与获得医疗服务的困难有关的问题。尽管 25 个国家已经制定了公平的干预措施，但没有一个国家为其实施分配预算。各国仍需要将其对卫生公平性的关注转化为有资金支持的、有针对性的干预措施，这些措施应伴随患者贯穿整个癌症护理全过程。
