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智利癌症现状之二:公平、创新与国家发展的研究、战略及分析框架更新

A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development.

作者信息

Vacarezza Cristóbal, Araneda Julieta, Gonzalez Pamela, Arteaga Oscar, Marcelain Katherine, Castellon Enrique A, Periera Ana, Khoury Maroun, Müller Bettina, Lecaros Juan Alberto, Salas Sofia P, Riquelme Arnoldo, Corvalan Alejandro H, de la Jara Jorge Jiménez, Ferreccio Catterina, Goic Carolina, Nervi Bruno, Roa Juan Carlos, Owen Gareth I

机构信息

Medical Public Health Residency Program, School of Public Health Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Independencia 939, Santiago, Chile.

Servicio de Salud del Reloncavi, Esmeralda 269, Puerto Montt, Chile.

出版信息

Biol Res. 2024 Dec 18;57(1):95. doi: 10.1186/s40659-024-00574-2.

Abstract

INTRODUCTION

Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy.

OBJECTIVES

Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care.

METHODS

Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders.

RESULTS

Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing.

CONCLUSIONS

The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.

摘要

引言

智利已达到发达国家水平,平均预期寿命超过81岁;然而,其医疗保健和研究系统尚未做好应对癌症带来的社会和经济负担的准备。十年前,作者对癌症基础设施进行了全面分析,并就以研究为导向的政治政策提出了一系列建议。

目的

对国家肿瘤学在政策、基础设施、性别平等、利益相关者参与和新挑战方面进行更新和评论。评估癌症研究的资金投入和分配情况。介绍肿瘤学研究、创新和患者护理发展的行动。

方法

通过整合经济、流行病学、私营和公共部门资源的客观系统指标以及政策分析,我们评估了癌症负担、基础设施和研究情况。我们分析了政府和私营部门的癌症数据库,并辅以对癌症利益相关者的访谈。

结果

政府政策和患者倡导促使人们认识到癌症负担,出台了一部癌症法和一项国家癌症计划。癌症已成为智利的首要死因(2022年有59,876例病例和31,440例癌症死亡),但仅有0.36%的国内生产总值用于研发。治疗方案的不平等现象依然存在。预防政策降低了烟草消费、通过软饮料摄入的糖分,并提高了人乳头瘤病毒疫苗的接种覆盖率。一个高质量的癌症研究群体正在壮大,国际资助的临床肿瘤学试验也在增加。

结论

癌症法推动了政策进步。预防政策对烟草和糖分摄入产生了影响,同时性别平等和护理不平等问题也进入了公共讨论范畴。癌症研究因缺乏投资而停滞不前。必须优先实施癌症登记和生物样本库建设,加强预防策略,发展人力资源,推动临床试验基础设施建设,并投资于新技术,以实现创新进步和公平的癌症护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/318d/11657627/91bc389d4af3/40659_2024_574_Fig1_HTML.jpg

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