Huq M Saiful, Acharya Sandhya C, Poudyal Saugat, Sharma Susmita, Silwal Sudhir R, Sapkota Simit, Gautam Manish, Haque Mohammad M, Uddin A F M Kamal, Gunasekara Sanjeeva, Babu K Govind, Tshomo Ugyen, Safi Ahmad J, Masood Ahmed I, Sumon Mostafa A, Purvin Shaila, Hai Mohammad A, Skinner Heath Devin, Avery Stephen, Ngwa Wilfred, Wijesooriya Krishni
Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
Clinical Oncology, Bir Hospital, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal.
Lancet Oncol. 2024 Dec;25(12):e650-e662. doi: 10.1016/S1470-2045(24)00514-X.
Cancer care in countries in the South Asian Association for Regional Cooperation (SAARC) is hindered by many challenges, including inadequate infrastructure, a shortage of skilled health-care professionals, and economic constraints. These factors contribute to disparities in timely diagnosis and treatment, leading to poorer health outcomes. Health-care systems within the region vary considerably, ranging from free public health care in Sri Lanka to predominantly out-of-pocket expenses in Bangladesh, highlighting inequities in financial access and service delivery for patients within this region. The absence of comprehensive national health insurance systems imposes substantial financial burdens on patients with cancer and their families, often resulting in catastrophic health-care costs. Paediatric oncology services reflect these disparities with greater clarity. Although Bangladesh has developed multiple treatment centres, issues such as delayed diagnoses and financial barriers persist. By contrast, countries such as Afghanistan and the Maldives have few specialised paediatric oncology services, necessitating costly referrals abroad that place large strains on families. Geriatric oncology remains underdeveloped across most SAARC nations, with few dedicated services and guidelines. Despite progress in India and Sri Lanka, gaps in specialised training and holistic care for older patients remain. Addressing these disparities requires coordinated efforts, including improving health-care infrastructure, expanding insurance coverage, and fostering regional collaborations. Implementing comprehensive national cancer control programmes across SAARC nations, leveraging intercountry networks, and ensuring political commitment are essential to achieving equitable cancer care and advancing Sustainable Development Goals in the region.
南亚区域合作联盟（南盟）成员国的癌症护理面临诸多挑战，包括基础设施不足、熟练医护专业人员短缺以及经济限制。这些因素导致在及时诊断和治疗方面存在差异，进而导致更差的健康结果。该区域内的医疗保健系统差异很大，从斯里兰卡的免费公共医疗保健到孟加拉国主要的自费医疗费用，凸显了该区域内患者在经济可及性和服务提供方面的不公平。缺乏全面的国家医疗保险系统给癌症患者及其家庭带来了巨大的经济负担，常常导致灾难性的医疗费用。儿科肿瘤服务更清晰地反映了这些差异。尽管孟加拉国已经建立了多个治疗中心，但诊断延迟和经济障碍等问题仍然存在。相比之下，阿富汗和马尔代夫等国几乎没有专门的儿科肿瘤服务，需要将患者转诊到国外，费用高昂，给家庭带来巨大压力。大多数南盟国家的老年肿瘤学仍然不发达，专门服务和指南很少。尽管印度和斯里兰卡取得了进展，但老年患者的专业培训和整体护理方面仍存在差距。解决这些差异需要协调一致的努力，包括改善医疗保健基础设施、扩大保险覆盖范围以及促进区域合作。在南盟国家实施全面的国家癌症控制计划、利用国家间网络并确保政治承诺对于在该区域实现公平的癌症护理和推进可持续发展目标至关重要。
