School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, Irvine, USA.
National Cancer Centre Singapore, Singapore, Singapore.
Cancer Med. 2024 Sep;13(17):e70234. doi: 10.1002/cam4.70234.
The global cancer burden is rising, particularly in low- and middle-income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High-Income Countries (HIC).
An online cross-sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice-related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi-squared or Fisher's exact test for cross-sectional analyses, and a multivariable logistic regression model was employed for statistical analysis.
A total of 218 active members participated, with one-quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non-US-based) respondents, while US-based respondents identified racial/ethnic minorities as facing more disparities.
This global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.
全球癌症负担不断增加，尤其是在中低收入国家（LMIC），这突显了一个关键的研究差距，即对支持性护理获取方面的差异缺乏了解。为了解决这个问题，多国支持癌症治疗协会（MASCC）健康差异委员会发起了一项全球调查，以调查和描绘这些差异。本研究旨在探讨和比较中低收入国家与高收入国家（HIC）之间的支持性护理获取差异。
对 MASCC 的活跃成员进行了在线横断面调查。代表不同医疗保健专业的成员收到了电子邮件邀请。该调查为期 3 周，包括以下部分：（1）社会人口统计学信息；（2）他们所在地区/国家在临床服务/实践方面的差异；（3）他们所在地区或国家面临差异的人群群体。使用卡方检验或 Fisher 确切检验进行横断面分析，使用多变量逻辑回归模型进行统计分析。
共有 218 名活跃成员参与了调查，其中四分之一（26.6%）来自 LMIC，18.4%为少数民族。及时的癌症治疗（43.7%）和及时的支持性护理（45.0%）是全球最紧迫的差异。值得注意的是，来自 LMIC 的参与者强调癌症药物的可负担性（56.4%）和支持性护理指南的实施（56.4%）是关键问题。来自 LMIC 和非美国的 HIC（非美国）受访者都认为经济弱势群体更有可能面临差异，而美国的受访者则认为种族/族裔少数民族面临更多的差异。
这项全球调查揭示了中低收入国家与高收入国家之间在癌症支持性护理方面存在显著差异，特别是在中低收入国家，药物的可负担性和指南的实施是重点。解决这些差异需要有针对性的干预措施，考虑到特定的区域优先事项。
