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全球肿瘤学:应对低收入和中等收入国家的差距并促进创新

Global Oncology: Tackling Disparities and Promoting Innovations in Low- and Middle-Income Countries.

作者信息

Barragan-Carillo Regina, Asirwa Fredrick Chite, Dienstmann Rodrigo, Pendhakar Dinesh, Ruiz-Garcia Erika

机构信息

Instituto Nacional de Cancerología, Mexico City, Mexico.

International Cancer Institute, Eldoret, Kenya.

出版信息

Am Soc Clin Oncol Educ Book. 2025 Jun;45(3):e473930. doi: 10.1200/EDBK-25-473930. Epub 2025 Jun 17.

Abstract

Global cancer incidence is projected to rise dramatically, with over 35 million new cases anticipated by 2050, disproportionately affecting low- and middle-income countries (LMICs) where up to 70% of cancer deaths are expected to occur. This manuscript provides an in-depth assessment of the structural, economic, and sociocultural barriers that drive cancer care disparities in LMICs, including limited access to prevention, diagnosis, treatment, and palliative care services. Key challenges include shortages in oncology workforce, diagnostic infrastructure, radiotherapy access, and participation in clinical trials. Socioeconomic inequities, stigma, and high out-of-pocket costs further exacerbate delayed care and poor outcomes. Some innovative interventions have improved access and quality of cancer care in resource constrained settings. These include task-shifting models, digital health tools, community-based awareness and screening programs, and South-South collaborations that foster local drug innovation and manufacturing. It also explores emerging strategies in precision medicine, AI-assisted decision making, and tele-oncology tailored to LMICs. The role of public-private partnerships, sustainable financing, and international collaborations in advancing cancer control is critically examined. The future of global oncology hinges on a shift from fragmented, reactive responses to coordinated, data-driven, and sustainable strategies. By strengthening health systems and embracing context-sensitive innovation, the global community can address the widening cancer care gap and improve outcomes for vulnerable populations worldwide.

摘要

全球癌症发病率预计将急剧上升,到2050年预计将有超过3500万新病例,低收入和中等收入国家(LMICs)受到的影响尤为严重,预计这些国家高达70%的癌症死亡将发生在此。本手稿深入评估了导致LMICs癌症护理差距的结构、经济和社会文化障碍,包括预防、诊断、治疗和姑息治疗服务的获取受限。关键挑战包括肿瘤学劳动力短缺、诊断基础设施不足、放疗机会有限以及参与临床试验的机会少。社会经济不平等、耻辱感和高额自付费用进一步加剧了护理延迟和不良后果。一些创新干预措施改善了资源有限环境下癌症护理的可及性和质量。这些措施包括任务转移模式、数字健康工具、基于社区的宣传和筛查项目,以及促进当地药物创新和生产的南南合作。它还探讨了针对LMICs的精准医学、人工智能辅助决策和远程肿瘤学的新兴策略。批判性地审视了公私伙伴关系、可持续融资和国际合作在推进癌症控制方面的作用。全球肿瘤学的未来取决于从零散、被动的应对方式转向协调、数据驱动和可持续的策略。通过加强卫生系统并采用因地制宜的创新方法,全球社会可以缩小不断扩大 的癌症护理差距,改善全世界弱势群体的治疗效果。

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