乳腺癌治疗的差异——与预防、诊断和治疗相关的因素如何导致不平等。

Disparities in Breast Cancer Care-How Factors Related to Prevention, Diagnosis, and Treatment Drive Inequity.

作者信息

Wilkerson Avia D, Gentle Corey K, Ortega Camila, Al-Hilli Zahraa

机构信息

Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Breast Center, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

出版信息

Healthcare (Basel). 2024 Feb 12;12(4):462. doi: 10.3390/healthcare12040462.

Abstract

Breast cancer survival has increased significantly over the last few decades due to more effective strategies for prevention and risk modification, advancements in imaging detection, screening, and multimodal treatment algorithms. However, many have observed disparities in benefits derived from such improvements across populations and demographic groups. This review summarizes published works that contextualize modern disparities in breast cancer prevention, diagnosis, and treatment and presents potential strategies for reducing disparities. We conducted searches for studies that directly investigated and/or reported disparities in breast cancer prevention, detection, or treatment. Demographic factors, social determinants of health, and inequitable healthcare delivery may impede the ability of individuals and communities to employ risk-mitigating behaviors and prevention strategies. The disparate access to quality screening and timely diagnosis experienced by various groups poses significant hurdles to optimal care and survival. Finally, barriers to access and inequitable healthcare delivery patterns reinforce inequitable application of standards of care. Cumulatively, these disparities underlie notable differences in the incidence, severity, and survival of breast cancers. Efforts toward mitigation will require collaborative approaches and partnerships between communities, governments, and healthcare organizations, which must be considered equal stakeholders in the fight for equity in breast cancer care and outcomes.

摘要

在过去几十年中,由于预防和风险调整策略更有效、影像检测、筛查及多模式治疗算法取得进展,乳腺癌患者的生存率显著提高。然而,许多人注意到,不同人群和人口群体从这些改善中获得的益处存在差异。本综述总结了已发表的文献,这些文献阐述了乳腺癌预防、诊断和治疗方面现代差异的背景情况,并提出了减少差异的潜在策略。我们搜索了直接调查和/或报告乳腺癌预防、检测或治疗差异的研究。人口因素、健康的社会决定因素以及不公平的医疗服务提供可能会阻碍个人和社区采取降低风险行为和预防策略的能力。不同群体在获得高质量筛查和及时诊断方面存在差异,这对最佳治疗和生存构成了重大障碍。最后,获得医疗服务的障碍和不公平的医疗服务提供模式强化了护理标准的不公平应用。这些差异累积起来,构成了乳腺癌发病率、严重程度和生存率方面显著差异的基础。减轻差异的努力将需要社区、政府和医疗组织之间的合作方法和伙伴关系,在争取乳腺癌护理和治疗结果公平的斗争中,这些方面必须被视为平等的利益相关者。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索