Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom.
Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom.
JCO Glob Oncol. 2023 Aug;9:e2300111. doi: 10.1200/GO.23.00111.
The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients.
Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives.
The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) ( = 83). Others included cancer registries ( 62); prevention ( = 52); end-of-life care ( = 53); and value-based and affordable care ( = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly ( = 36). Others included treatment schedule interruption ( = 24); cost-effective reduction of COVID-19 morbidity/mortality ( = 19); and pandemic preparedness ( = 18).
Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access.
在全球范围内，癌症研究的后 COVID-19 资金环境变得越来越具有挑战性，特别是在资源匮乏地区（RCR）缺乏强大的研究生态系统的情况下。我们旨在根据研究人员和患者的意见，为资源有限国家的癌症研究确定优先领域。
联系了来自低资源医疗保健系统的癌症专家（世界银行为低收入和中等收入国家；N = 151）参与了一项经过修改的共识寻求 Delphi 调查，该调查由两轮组成。在第一轮中，参与者（n = 69）对预先确定的潜在研究重点领域（ARPs）的重要性进行了评分，并提出了缺失的 ARPs。在第二轮中，相同的参与者（n = 49）对第一轮中预先确定和建议的 ARPs 的综合清单进行了评分，然后进行了强制性选择优先级排序练习。综合投票得分（-分数）用于对 ARPs 进行排名。重要性评分进行了描述性总结。结果与国际患者倡导组织的代表进行了讨论。
排名最高的 ARP 是研究如何根据现有资源调整指南或治疗策略（特别是系统疗法）（ = 83）。其他包括癌症登记处（62）；预防（52）；临终关怀（53）；以及基于价值和负担得起的护理（51）。排名最高的 COVID-19/癌症 ARP 是将大流行期间所学到的可以后续维持的策略纳入进来（ = 36）。其他包括中断治疗计划（ = 24）；降低 COVID-19 发病率/死亡率的成本效益方法（ = 19）；以及大流行准备（ = 18）。
RCR 癌症研究人员青睐的战略优先领域与适应性治疗指南；可持续实施癌症登记处；预防策略；基于价值和负担得起的癌症护理；投资于研究能力建设；针对当地癌症风险因素的流行病学研究；以及预防和护理机会均等的斗争有关。
