How Should Low- and Middle-Income Countries Motivate Equity in Cancer Prevention and Control?

List, Justin M.; O’Connor, Joanne

doi:10.1001/amajethics.2020.147

Cited by 15 publications

(7 citation statements)

References 19 publications

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“…Some of these challenges may be corrected by rectifying the general shortage of healthcare professionals who manage patient loads that are often significantly higher than in most high-income countries [141]. Resource constraints further limit access to cancer drugs deemed essential by the World Health Organization [142,143] as well as the capacity for population-based cancer registries [144]. Without adequate cancer-related surveillance, it is difficult to develop effective policy priorities for improving cancer outcomes and health equity in LMICs.…”

Section: Opportunities For Future Researchmentioning

confidence: 99%

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Ryder‐Burbidge

Diaz

Barr

et al. 2021

Cancers

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Risk factors associated with late effects in survivors of adolescent and young adult (AYA) cancer are poorly understood. We conducted a systematic scoping review to identify cohort studies published in English from 2010–2020 that included: (1) cancer survivors who were AYAs (age 15–39 years) at diagnosis and (2) outcomes of subsequent malignant neoplasms (SMNs), chronic conditions, and/or late mortality (>5 years postdiagnosis). There were 652 abstracts identified and, ultimately, 106 unique studies were included, of which 23, 34, and 54 studies related to the risk of SMNs, chronic conditions, and mortality, respectively. Studies investigating late effects among survivors of any primary cancer reported that AYA cancer survivors were at higher risk of SMN, chronic conditions, and all-cause mortality compared to controls. There was an indication that the following factors increased risk: radiation exposure (n = 3) for SMNs; younger attained age (n = 4) and earlier calendar period of diagnosis (n = 3) for chronic conditions; and non-Hispanic Black or Hispanic (n = 5), low socioeconomic status (n = 3), and earlier calendar period of diagnosis (n = 4) for late mortality. More studies including the full AYA age spectrum, treatment data, and results stratified by age, sex, and cancer type are needed to advance knowledge about late effects in AYA cancer survivors.

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Section: Opportunities For Future Researchmentioning

confidence: 99%

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Ryder‐Burbidge

Diaz

Barr

et al. 2021

Cancers

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“…Public health surveillance and cancer control coalitions have been posited as two key public health levers necessary to reduce cancer inequities in LMICs. 17 Public health surveillance relies on strong laboratory health services. The Ebola outbreak in 2014 exposed Liberia's fragmented surveillance system and galvanized the country's investments in diagnostics and surveillance.…”

Section: Discussionmentioning

confidence: 99%

Program Planning to Develop Infrastructure for Cancer Care in Liberia

Beddoe

Jallah

Dahn

2022

JCO Global Oncology

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Liberia's health infrastructure was completely devastated after 14 years of back-to-back civil war. Postconflict rebuilding of the country's health workforce and infrastructure has become a priority. Initially, the focus was on the diagnosis and treatment of communicable diseases that caused multigenerational family losses. With the increasing burden of noncommunicable diseases, however, the country has turned its attention to addressing diabetes, cancer, and cardiovascular and respiratory diseases, with the development of the noncommunicable disease unit under the Ministry of Health. Recovering from another setback caused by the Ebola virus outbreak in 2014, the country assembled a diverse group of stakeholders to form Liberia's first National Cancer Committee. To structure a program that would address the increasing burden of cervical and breast cancers, the major cause of mortality among reproductive-aged women in Liberia, input from the International Atomic Energy Agency was critical. This article describes the preplanning activities for developing infrastructure to support cancer care in Liberia that occurred between 2013 and 2020 and is still ongoing. This case study is intended to serve as a planning guide for countries with limited resources as they work toward the goal of eliminating cervical cancer and developing infrastructure to address their country's burden of all cancers.

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“… 17 In contrast, about 70% of cancer deaths occur in LMICs. 18 The survival for EWS in children in LMICs falls behind HICs due to the nonavailability of timely, effective, and affordable treatment. 19 The increase in cancer burden in LMICs poses a threat to already frail health care and economic infrastructure.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of outpatient administration of ifosfamide and etoposide for pediatric patients with Ewing sarcoma in a resource‐limited setting amid the COVID‐19 pandemic

Sarfraz

Saeed

2022

Pediatric Blood & Cancer

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Background: To assess feasibility and safety of outpatient administration of ifosfamide and etoposide (IE) for pediatric Ewing sarcoma (EWS) patients in a resource-limited setting amid the COVID-19 pandemic. Materials and Methods:Retrospective study of patients with EWS who received outpatient IE from January 2020 until January 2021 at our institution. Ifosfamide 1800 mg/m 2 was given for 5 days with MESNA (2-mercaptoethane sulfonate sodium) infusion and additional boluses before and after 9 hours of hydration. Patients >10 years of age with the ability to drink orally at home, no pre-existing renal dysfunction or history of hematuria were included. They were monitored for hemorrhagic cystitis with a urine dipstick before, midway, and at end of infusion. A urine analysis was done 24 hours after the last dose of ifosfamide.Results: Forty-seven (100%) cycles were given as outpatient during the study period.Thirty-five (74%) cycles were given on time, two (4%) cycles were delayed due to mucositis, two (4%) due to delayed count recovery, and eight (18%) due to unavailability of outpatient appointments. The median interval between these cycles was 15 days (range 14-44 days). No episode of hemorrhagic cystitis was reported. Urine analysis was not done at 24 hours for 27 (58%) cycles, so microscopic hematuria may have been missed. This outpatient protocol saved 32% (USD 299) per cycle in cost and 282 days of hospitalization. Conclusion:Outpatient administration of IE for pediatric patients with EWS is feasible, safe, and cost-effective during the COVID-19 pandemic.

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How Should Low- and Middle-Income Countries Motivate Equity in Cancer Prevention and Control?

Cited by 15 publications

References 19 publications

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Program Planning to Develop Infrastructure for Cancer Care in Liberia

Feasibility and safety of outpatient administration of ifosfamide and etoposide for pediatric patients with Ewing sarcoma in a resource‐limited setting amid the COVID‐19 pandemic

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