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及时进行分子检测结果的障碍和不平等获取:解决加拿大癌症护理延误的不平等问题。

Barriers and Unequal Access to Timely Molecular Testing Results: Addressing the Inequities in Cancer Care Delays across Canada.

机构信息

Division of Medical Oncology, QEII Health Sciences Centre, Halifax, NS B3H 2Y9, Canada.

Division of Medical Oncology, Sinai Health, Toronto, ON M5G 1X5, Canada.

出版信息

Curr Oncol. 2024 Mar 6;31(3):1359-1375. doi: 10.3390/curroncol31030103.

Abstract

Genomic medicine is a powerful tool to improve diagnosis and outcomes for cancer patients by facilitating the delivery of the right drug at the right dose at the right time for the right patient. In 2023, a Canadian conference brought together leaders with expertise in different tumor types. The objective was to identify challenges and opportunities for change in terms of equitable and timely access to biomarker testing and reporting at the education, delivery, laboratory, patient, and health-system levels in Canada. Challenges identified included: limited patient and clinician awareness of genomic medicine options with need for formal education strategies; failure by clinicians to discuss genomic medicine with patients; delays in or no access to hereditary testing; lack of timely reporting of results; intra- and inter-provincial disparities in access; lack of funding for patients to access testing and for laboratories to provide testing; lack of standardized testing; and impact of social determinants of health. Canada must standardize its approach to biomarker testing across the country, with a view to addressing current inequities, and prioritize access to advanced molecular testing to ensure systems are in place to quickly bring innovation and evidence-based treatments to Canadian cancer patients, regardless of their place of residence or socioeconomic status.

摘要

基因组医学是一种强大的工具,可以通过在正确的时间为正确的患者提供正确的药物剂量来改善癌症患者的诊断和治疗效果。2023 年,加拿大的一次会议汇集了在不同肿瘤类型方面具有专业知识的领导者。会议的目的是确定在加拿大教育、服务提供、实验室、患者和医疗体系层面上,公平且及时地获得生物标志物检测和报告方面的挑战和变革机会。会议确定的挑战包括:患者和临床医生对基因组医学选择的认识有限,需要制定正式的教育策略;临床医生未能与患者讨论基因组医学;遗传性检测的延迟或无法进行;结果报告不及时;省内和省内之间的服务获取存在差异;患者无法获得检测资金,实验室也无法提供检测服务;缺乏标准化检测;以及健康的社会决定因素的影响。加拿大必须在全国范围内标准化其生物标志物检测方法,以解决当前的不平等问题,并优先考虑获得先进的分子检测,以确保建立系统,快速将创新和基于证据的治疗方法带给加拿大癌症患者,无论他们的居住地点或社会经济地位如何。

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