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结直肠癌治疗结果:低收入和中等收入国家以及美国农村地区资源有限环境的比较综述

Colorectal Cancer Outcomes: A Comparative Review of Resource-Limited Settings in Low- and Middle-Income Countries and Rural America.

作者信息

Jacobson Clare E, Harbaugh Calista M, Agbedinu Kwabena, Kwakye Gifty

机构信息

Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.

Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI 48109, USA.

出版信息

Cancers (Basel). 2024 Sep 27;16(19):3302. doi: 10.3390/cancers16193302.

Abstract

Colorectal cancer remains a significant global health challenge, particularly in resource-limited settings where patient-centered outcomes following surgery are often suboptimal. Although more prevalent in low- and middle-income countries (LMICs), segments of the United States have similarly limited healthcare resources, resulting in stark inequities even within close geographic proximity. This review compares and contrasts colorectal cancer outcomes in LMICs with those in resource-constrained communities in rural America, utilizing an established implementation science framework to identify key determinants of practice for delivering high-quality colorectal cancer care. : Barriers and innovative, community-based strategies aimed at improving patient-centered outcomes for colorectal cancer patients in low resource settings are identified. We explore innovative approaches and community-based strategies aimed at improving patient-centered outcomes, highlighting the newly developed colorectal surgery fellowship in Sub-Saharan Africa as a model of innovation in this field. By exploring these diverse contexts, this paper proposes actionable solutions and strategies to enhance surgical care of colorectal cancer and patient outcomes, ultimately aiming to inform global health practices, inspire collaboration between LMIC and rural communities, and improve care delivery across various resource settings.

摘要

结直肠癌仍然是一项重大的全球健康挑战,尤其是在资源有限的环境中,手术后以患者为中心的治疗结果往往不尽如人意。虽然在低收入和中等收入国家(LMICs)更为普遍,但美国部分地区的医疗资源同样有限,即使在地理位置相近的地区也存在明显的不公平现象。本综述比较并对比了LMICs与美国农村资源受限社区的结直肠癌治疗结果,利用既定的实施科学框架确定提供高质量结直肠癌护理的关键实践决定因素。确定了在资源匮乏环境中旨在改善结直肠癌患者以患者为中心的治疗结果的障碍和创新的、基于社区的策略。我们探索旨在改善以患者为中心的治疗结果的创新方法和基于社区的策略,强调撒哈拉以南非洲新设立的结直肠外科奖学金是该领域创新的典范。通过探索这些不同的背景,本文提出了可采取的解决方案和策略,以加强结直肠癌的手术护理和患者治疗结果,最终旨在为全球卫生实践提供信息,激发LMICs与农村社区之间的合作,并改善各种资源环境下的医疗服务提供。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50ce/11475417/f67fb60d67c9/cancers-16-03302-g001.jpg

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