Center for Global Health, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
Kenya Hospices and Palliative Care Association, Nairobi, Kenya.
J Cancer Surviv. 2023 Jun;17(3):634-645. doi: 10.1007/s11764-022-01320-x. Epub 2023 Jan 19.
In 2017, the World Health Organization urged member states to develop and implement national cancer control plans (NCCPs) and to anticipate and promote cancer survivor follow-up care, which is a critical yet often overlooked component of NCCPs. This study aims to examine the inclusion of cancer survivorship-related strategies and objectives in NCCPs of African countries.
Independent reviewers extracted strategies, objectives, and associated indicators related to survivorship care from 21 current or recently expired NCCPs in African countries. Building on a similar analysis of the US state cancer control plans, reviewers categorized these strategies according to an adapted version of the ten recommendations for comprehensive survivorship care detailed in the 2006 National Academy of Medicine report.
A total of 202 survivorship-related strategies were identified, with all NCCPs including between 1 and 23 references to survivorship. Eighty-three (41%) strategies were linked to measurable indicators, and 128 (63%) of the survivorship-related strategies were explicitly focused on palliative care. The most frequent domains referenced were models of coordinated care (65 strategies), healthcare professional capacity (45), and developing and utilizing evidence-based guidelines (23). The least-referenced domains were survivorship care plans (4) and adequate and affordable health insurance (0).
The results of this study indicate that survivorship objectives and strategies should extend beyond palliative care to encompass all aspects of survivorship and should include indicators to measure progress.
Stakeholders can use this baseline analysis to identify and address gaps in survivorship care at the national policy level.
2017 年，世界卫生组织敦促成员国制定和实施国家癌症控制计划（NCCP），并预测和促进癌症幸存者的后续护理，这是 NCCP 的一个关键但经常被忽视的组成部分。本研究旨在考察非洲国家 NCCP 中包含与癌症生存相关的策略和目标的情况。
独立审查员从非洲国家的 21 项现行或最近过期的 NCCP 中提取与生存相关的策略、目标和相关指标。在对美国州癌症控制计划进行类似分析的基础上，审查员根据 2006 年国家医学研究院报告中详细阐述的全面生存护理十项建议的改编版，对这些策略进行了分类。
共确定了 202 项与生存相关的策略，所有 NCCP 都包含 1 至 23 项与生存相关的参考。83 项（41%）策略与可衡量的指标相关联，128 项（63%）与生存相关的策略明确侧重于姑息治疗。最常提到的领域是协调护理模式（65 项策略）、医疗保健专业人员能力（45 项）和制定和利用基于证据的指南（23 项）。参考最少的领域是生存护理计划（4 项）和充足和负担得起的健康保险（0 项）。
本研究结果表明，生存目标和策略应超越姑息治疗，涵盖生存的各个方面，并应包括衡量进展的指标。
利益相关者可以利用此基线分析在国家政策层面确定和解决生存护理方面的差距。
