Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA; Dartmouth Cancer Center, Lebanon, NH, USA.
American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria, VA 22314, USA.
Hematol Oncol Clin North Am. 2024 Feb;38(1):1-12. doi: 10.1016/j.hoc.2023.08.001. Epub 2023 Sep 4.
Inequity exists along the continuum of cancer and cancer care delivery in the United States. Marginalized populations have later stage cancer at diagnosis, decreased likelihood of receiving cancer-directed care, and worse outcomes from treatment. These inequities are driven by historical, structural, systemic, interpersonal, and internalized factors that influence cancer across the pathologic and clinical continuum. To ensure equity in cancer care, interventions are needed at the level of policy, care delivery, interpersonal communication, diversity within the clinical workforce, and clinical trial accessibility and design.
在美国,癌症及其治疗的提供过程中存在不平等现象。边缘化群体在诊断时癌症已处于晚期,接受癌症治疗的可能性降低,治疗效果也更差。这些不平等现象是由历史、结构、系统、人际和内化等因素造成的,这些因素影响着癌症在病理和临床连续体上的发生和发展。为了确保癌症治疗的公平性,需要在政策、治疗提供、人际沟通、临床工作人员多样性以及临床试验可及性和设计等层面采取干预措施。