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全球资源匮乏地区的癌症外科手术:优势、劣势、机遇和威胁分析。

Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis.

机构信息

Harvard Medical School, Boston, Massachusetts, USA.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Cancer. 2023 Mar 1;129(5):671-684. doi: 10.1002/cncr.34630. Epub 2023 Jan 3.

Abstract

Global cancer surgery is an essential and complex component of oncologic care. This study aims to describe global cancer surgery literature since the 2015 Lancet Commission on Global Surgery and Cancer Surgery and perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A systematic search was performed in PubMed of global cancer surgery articles. Themes were extracted from the included studies based on the following criteria: (1) performed in low- or low-middle-income countries, (2) published during or after 2015, (3) published in peer-reviewed journals, (4) written in the English language, and (5) accessible to the authors. Themes were further grouped into strengths, weaknesses, opportunities, and threats (SWOT analysis). The search strategy identified 154 articles published from 1992 to 2022. Forty-six articles were included in the qualitative synthesis and SWOT analysis. Recurring themes included local epidemiologic studies, local innovations and feasibility studies, prioritizing quality of life outcomes, multidisciplinary team approaches, limited resources, health system gaps, lack of economic analyses, diverse cancer management strategies and priorities, inter-setting collaboration, research expansion, the coronavirus disease 2019 pandemic, and unchecked technological advancements. These strengths, weaknesses, opportunities, and threats were described and related to the themes of research, surgical systems strengthening, economics and financing, and political framing of the 2015 Lancet Commission on Global Cancer Surgery. SWOT analyses of global cancer surgery may be helpful in suggesting future strategies for this expanding field. PLAIN LANGUAGE SUMMARY: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected growth of cancer burden, the present gap in cancer surgery care in low-resource settings with stressed health care and surgical infrastructure risks further exacerbation. We present a strengths, weaknesses, opportunities, and threats analysis of recent global cancer surgery literature pertaining to low-resource settings.

摘要

全球癌症手术是肿瘤治疗中不可或缺且复杂的组成部分。本研究旨在描述自 2015 年柳叶刀全球手术与癌症外科委员会成立以来的全球癌症手术文献,并进行优势、劣势、机会和威胁(SWOT)分析。在 PubMed 中对全球癌症手术文献进行了系统检索。根据以下标准从纳入的研究中提取主题:(1)在低收入或中低收入国家进行,(2)在 2015 年或之后发表,(3)在同行评议期刊上发表,(4)用英文书写,(5)作者可获取。主题进一步分为优势、劣势、机会和威胁(SWOT 分析)。搜索策略确定了 1992 年至 2022 年期间发表的 154 篇文章。46 篇文章被纳入定性综合和 SWOT 分析。反复出现的主题包括当地流行病学研究、当地创新和可行性研究、优先考虑生活质量结果、多学科团队方法、有限的资源、卫生系统差距、缺乏经济分析、多样化的癌症管理策略和重点、跨环境合作、研究扩展、2019 年冠状病毒病(COVID-19)大流行和不受控制的技术进步。这些优势、劣势、机会和威胁进行了描述,并与 2015 年柳叶刀全球癌症外科委员会的研究主题、外科系统加强、经济和融资以及政治框架相关联。全球癌症手术的 SWOT 分析可能有助于为这个不断扩大的领域提出未来的策略。

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