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BackgroundThe global cancer burden is rising, particularly in low‐ and middle‐income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High‐Income Countries (HIC).MethodsAn online cross‐sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice‐related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi‐squared or Fisher's exact test for cross‐sectional analyses, and a multivariable logistic regression model was employed for statistical analysis.ResultsA total of 218 active members participated, with one‐quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non‐US‐based) respondents, while US‐based respondents identified racial/ethnic minorities as facing more disparities.ConclusionThis global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.
BackgroundThe global cancer burden is rising, particularly in low‐ and middle‐income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High‐Income Countries (HIC).MethodsAn online cross‐sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice‐related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi‐squared or Fisher's exact test for cross‐sectional analyses, and a multivariable logistic regression model was employed for statistical analysis.ResultsA total of 218 active members participated, with one‐quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non‐US‐based) respondents, while US‐based respondents identified racial/ethnic minorities as facing more disparities.ConclusionThis global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.
BackgroundCancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates.MethodsThis cross‐sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5‐year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural‐Urban Continuum Code (RUCC) classification was used to define counties as either urban (RUCC 1–3) or rural (RUCC 4–9). Multivariable logistic regression was used to evaluate the association between being far from a program and census‐tract level factors.ResultsIn total, 2133 CR/EO programs were identified nationwide. The distance from a program increased with decreasing population density: rural tracts were 17.68 ± 0.24 miles farther from a program compared with urban tracts (p < .001). Program proximity decreased as the neighborhood deprivation index increased (p < .001). Exercise oncology programs were less common than cancer rehabilitation programs in tracts with a larger proportion of minority residents (p < .001).ConclusionsPrior research has documented that underrepresented populations have worse cancer‐related symptoms and higher cancer mortality. Herein, the authors document their findings that these same populations are less likely to have proximity to CR/EO programs, which are associated with improved cancer‐related symptoms and cancer mortality outcomes. To realize the positive outcomes from CR/EO programming, efforts must focus on supporting expanded programming and sustainable payment for these services.
BackgroundThe authors examined baseline physical functional (PF) impairment among cancer outpatients in the National Cancer Institute Cancer Moonshot study Northwestern University Improving the Management of Symptoms During and Following Cancer Treatment (NU IMPACT). They hypothesized that PF impairment, measured with the Patient Reported Outcome Measurement Information System–Physical Function (PROMIS‐PF) survey, would (1) be common and more prevalent for patients receiving treatment compared with no treatment and (2) differ across tumor types, independent of cancer continuum phase.MethodsAdults who were diagnosed with cancer in NU IMPACT (n = 2273) were sampled, and their PROMIS‐PF scores were compared across tumor types and cancer continuum (curative, noncurative, or no treatment), with scores ≤40 indicating moderate–severe impairment. Multivariable logistic regression models were used to evaluate the relation among patient and cancer factors and PF scores using a 95% confidence interval.ResultsForty percent of the surveyed patients reported moderate–severe PF impairment. Patients with melanoma reported the least impairment, and those with lung cancer were 6.5 times more likely to have moderate–severe impairment (95% confidence interval, 2.393–17.769). The noncurative group was 1.5 times more likely to have moderate–severe impairment (95% confidence interval, 1.045–2.145; mean score, 43; p < .001) than the curative (mean score, 6) and no treatment (mean score, 48) groups. One‐third of those who reported PF impairment also had significant pain and/or fatigue.ConclusionsA sizeable minority experienced PF impairment across tumor types for which pain and/or fatigue co‐occurred, particularly in the noncurative group. The PROMIS‐PF survey effectively identified variations in physical function. Future studies will explore how screening for PF impairment can be used to refer patients for appropriate cancer rehabilitation services.
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