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晚期和转移性癌症治疗中现存的健康不平等问题。

Existing Health Inequities in the Treatment of Advanced and Metastatic Cancers.

作者信息

Nair Navya, Schlumbrecht Matthew

机构信息

Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, 1121 NW 14th St, Suite 345C, Miami, FL, 33136, USA.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

Curr Oncol Rep. 2024 Dec;26(12):1553-1562. doi: 10.1007/s11912-024-01617-3. Epub 2024 Nov 4.

Abstract

PURPOSE OF REVIEW

This study aims to identify health inequities related to the medical treatment and supportive care of patients with advanced/metastatic cancer and recommend solutions to promote health equity.

RECENT FINDINGS

Despite robust strides in the development of therapeutic strategies for advanced and metastatic cancer, significant disparities in treatment access and implementation exist. Race, socioeconomic status, gender, and geography represent just a few of the individual-level factors which contribute to challenges in treatment administration, thorough evaluation of germline genetics and tumor genomics, and quality palliative and end-of-life care. Given the increasing complexity of cancer treatments and our enhanced understanding of tumor biology, efforts to uniformly provide equitable and high-level care to all patients are needed. In this review we will discuss factors that contribute to health inequities in patients with advanced and metastatic cancer diagnoses, highlighting opportunities for intervention, ongoing challenges in change implementation, and national and international society recommendations to eliminate disparities. Acknowledging existing inequities and engaging in multilevel discourse with key stakeholders is needed to optimize care practices to the benefit of all patients.

摘要

综述目的

本研究旨在确定与晚期/转移性癌症患者的医学治疗和支持性护理相关的健康不平等问题,并推荐促进健康公平的解决方案。

最新发现

尽管在晚期和转移性癌症治疗策略的发展方面取得了显著进展,但在治疗可及性和实施方面仍存在重大差异。种族、社会经济地位、性别和地理位置只是导致治疗管理、种系遗传学和肿瘤基因组学的全面评估以及高质量姑息治疗和临终关怀面临挑战的部分个体层面因素。鉴于癌症治疗的复杂性日益增加,以及我们对肿瘤生物学的深入了解,需要努力为所有患者统一提供公平和高水平的护理。在本综述中,我们将讨论导致晚期和转移性癌症诊断患者健康不平等的因素,强调干预机会、变革实施中持续存在的挑战,以及国家和国际社会消除差异的建议。认识到现有的不平等现象,并与关键利益相关者进行多层次的讨论,对于优化护理实践以造福所有患者是必要的。

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