National cancer control plans (NCCPs) are complex public health programs that incorporate evidence-based cancer control strategies to improve health outcomes for all individuals in a country. Given ...the scope of NCCPs, small and vulnerable populations, such as patients with childhood cancer, are often missed. To support planning efforts, a rapid, modifiable tool was developed that estimates a context-specific national budget to fund pediatric cancer programs, provides 5-year scale-up scenarios, and calculates annual cost-effectiveness.
The tool was codeveloped by teams of policymakers, clinicians, and public health advocates in Zimbabwe, Zambia, and Uganda. The 11 costing categories included real-world data, modeled data, and data from the literature. A base-case and three 5-year scale-up scenarios were created using modifiable inputs. The cost-effectiveness of the disability-adjusted life years averted was calculated. Results were compared with each country's projected gross domestic product per capita for 2022 through 2026.
The number of patients/total budget for year 1 was 250/$1,109,366 for Zimbabwe, 280/$1,207,555 for Zambia, and 1000/$2,277,397 for Uganda. In year 5, these values were assumed to increase to 398/$5,545,445, 446/$4,926,150, and 1594/$9,059,331, respectively. Base-case cost per disability-adjusted life year averted/ratio to gross domestic product per capita for year 1, assuming 20% survival, was: $807/0.5 for Zimbabwe, $785/0.7 for Zambia, and $420/0.5 for Uganda.
This costing tool provided a framework to forecast a budget for childhood-specific cancer services. By leveraging minimal primary data collection with existing secondary data, local teams obtained rapid results, ensuring that childhood cancer budgeting is not neglected once in every 5 to 6 years of planning processes.
The role of a healthy lifestyle in improving the prognosis of many cancers is well known. The aim of this study is to describe the characteristics and lifestyles of a cohort of long-term breast ...cancer survivors in order to gain useful information to plan targeted educational interventions. This retrospective study involved patients registered at the Oncology Service of the ASL. Napoli 1 who had survived at least 5 years post-diagnosis of breast cancer. The data were collected both from the medical records and through a telephone interview. Statistical analysis was performed with Stata 10.1. The study found that there is a high proportion of women diagnosed under the age of 40, and with second primary neoplasms, however with a fairly high average survival rate. The women interviewed displayed a good willingness to be healthy, but intervention is still required regarding obesity and being overweight.
Introduction. Main oncologic indicators such as morbidity, mortality, early detection of malignant tumors, one-year mortality rate, noticeably differ not only among the countries but also among the ...regions of one country, and even more among the territories of one region. Oncological service informatization let us evaluate the target indicators in each territory unit of the region at any given time and to reveal the actual problems.The object of the work was to find out the differences in one-year oncological mortality rate among the territories of Sverdlovsk Region and to reveal the relation of it with the distribution of stages of detected oncological cases and with the availability of anticancer drug therapy (ADT).Materials and methods. Indicators of one-year mortality rate, distribution of stages of new cases, specialized treatment performed, were received from the regional oncological informational system ONCOR. The analysis of data on 32758 ADT courses conducted to patients from 60 districts of the Sverdlovsk region in the first 6 months of 2020 was carried out.Results and discussion. The number of courses held varied from 33 to 1 213, unique schemes – from 9 to 267. We analyzed the accessibility of ADT based on the relative indicators such as density of ADT (the ratio of the number of courses carried out to patients from a given territory to those registered in each territory) and diversity of ADT (the ratio of unique patterns of ADT in patients from a given territory to the number of registered patients in each territory). The density of ADT ranged from 11,8 to 108,3 courses per 100 registered patients, the variety of PLL – from 0,7 to 10 schemes per 100 registered patients. A relationship was revealed between the distribution by stages of detected cases of malignant neoplasms and one-year mortality, between the percentage of stage IV and the density of ADT. The density of ADT influenced the one-year mortality rate even with the leveling of the effect of the proportion of stage IV.Conclusion. The regional oncological system allows to demonstrate territorial differences in the indicators of the oncological service and the availability of specialized treatment. The density of ADT influenced the one-year mortality rate. The received information about the fulfillment in medical organizations at the place of patient’s residence the oncological dispensary appointments should be considered when making changes to regional orders for routing patients with malignant tumors.
The present study aimed at identifying factors that are associated with the frequency and duration of psycho-oncological sessions.
In a retrospective single-center study, data of all patients who ...made use of the psycho-oncological service (POS) at the University Hospital Erlangen from April 2017 - March 2018 were registered.
Over the course of one year, N = 1601 patients made use of the POS.
In the hospital's digital documentation system, relevant data such as frequency of sessions, duration of sessions, gender, age, family status, preexisting mental disorder, prior psychotherapy, cancer entity (type of cancer) and treatment modality were recorded. Socio-demographic and clinical parameters were analyzed to predict frequency and duration of the psycho-oncology sessions.
Regression analyses revealed that among POS users, women, younger patients, patients with a longer hospital stay and those with a preexisting mental disorder attended significantly more sessions than other patients (p < .001). Patients with skin cancer had significantly fewer POS sessions than those with a hematological diagnosis. Also, patients who had undergone surgery had significantly fewer sessions than patients with pharmacological treatment. Younger age and a longer hospital stay significantly predicted longer sessions (p < .001). In the regression model, patients with brain tumors and lung cancer had significantly longer sessions than patients with skin cancer.
With the identification of specific risk groups that require more and longer sessions, we can provide the basis for more patient-tailored intervention approaches and better scheduling according to the patients' needs. However, our results also suggest that the frequency and duration of POS sessions also depend on illness- and treatment-related criteria, e.g. the length of the hospital stay.
Nuclear Medicine Kaprin, A. D.; Smirnov, V. P.
Herald of the Russian Academy of Sciences,
05/2021, Volume:
91, Issue:
3
Journal Article
Open access
This article is dedicated to the history of the formation and development of radiation medicine, which is becoming increasingly widespread. Radiation treatment of various benign and malignant ...neoplasms with the help of contact use of ionizing radiation sources is called brachytherapy. To date, clinical brachytherapy has been divided into three areas: high-dose/high-power, low-dose/low-power, and electronic.
Founded in the early 1980s, the Unit of Radionuclide Therapy at the Tsyb Medical Radiological Research Center (Obninsk), a branch of the National Medical Research Radiological Center of the Russian Ministry of Health, is the first and largest medical institution in Russia where radionuclides are used therapeutically. The authors conclude their review by identifying the main trends in the global nuclear medicine of the future.
Background: The appearance of symptoms that may be related to the worsening of the disease, as well as the toxicity of chemotherapy treatment or an acute complication, are the most frequent reasons ...for access to the emergency room (ER) for patients with cancer. To date, the Italian territorial health services, as well as local preventive medicine, are unable to provide adequate management of patients with cancer and, for this reason, diagnostic delays and inappropriate hospitalization in the oncology departments have occurred; moreover, it has been observed that many patients receive the first diagnosis of cancer directly in the ER, where the experience in the oncology field is often inadequate. Objectives: Cardarelli Hospital, in Naples, started twenty-two month Experimental Oncological Emergency Service, under the supervision of its own Oncology Department, with the double main objectives of encouraging de-hospitalization and improving diagnostic and therapeutic performance. Methods: We have developed a methodological protocol for patients’ admission to the ER, assuming that the host physician transfers patients with suspected cancer to a new hospital figure, the ER oncologist, who acts as supervisor and coordinator. The first consultation was carried out together with one or more specialists, identified by the supervisor. Based on their characteristics, the patients were divided into 4 categories: (1) Patients with a known diagnosis of cancer and already undergoing anticancer treatments; (2) patients who show complications due to ongoing cancer treatments; (3) patients who no longer respond to anticancer treatments due to the worsening of the disease; (4) patients who are first diagnosed with cancer in the ER. Each individual cohort of patients was directed towards what we have called diagnostic-therapeutic assistance paths (PDTA), specific protocols for each type of patient, which allowed us to reduce the time to diagnosis. Results: According to the data, the average hospitalization time for patients with lung cancer who followed the study was 10 days, compared to 16 days for patients who did not undergo cancer screening in the ER. Another relevant result demonstrated the improvement in the quality and efficiency of medical services by including first aid in the management of cancer patients regards de-hospitalization. In fact, thanks to the experimental protocol we applied, we were able to de-hospitalize 484 patients directly from the ER, which are over 34% of the total. Conclusions: Close integration between hospital medical fields and territorial medicine could improve the quality of cancer treatment and the efficiency of health services management. All of this without affecting the costs of public healthcare because of the considerable improvement in performance which allowed important savings.
The growing incidence and prevalence of civilization diseases is prompting national and transnational entities to seek instruments that would reverse epidemiological trends. Not without significance ...is the need to design such solutions that are going to provide an improved relation between the costs incurred to maintain health or recovery and the profit for citizens of continuing to function in good health. In its strategic documents, the European Union indicates the most important development goals in each financial perspective and the tools necessary to achieve them. In the Europe 2020 strategy, a cohesion policy was indicated as an important tool for the implementation of development goals, focusing on supporting activities leading to the equalisation of economic and social conditions in all regions of EU countries. The implementation of one of the three basic priorities of the Europe 2020 strategy, which is inclusive growth-supporting an economy with a high level of employment and ensuring social and territorial cohesion-assumes, among others, that in 2020, the population at risk of poverty and social exclusion will decrease by 20 million and that the employment rate in the EU will increase to 75%. Meeting the objectives will not be possible without a holistic coordinated approach to healthcare at the national and regional level in accordance with the principle of "health in all policies". It also requires the involvement of various sources of financing, including structural funds. The EU's prioritisation of the problems related to ensuring decent conditions for achieving health resulted in the mobilisation of structural funds for actions taken in the healthcare sector. Of particular importance are those actions which are taken to prevent, alleviate, and prevent oncological diseases. An additional contribution to undertaking actions aimed at preventing oncological diseases are the high and often neglected social costs incurred by societies. The goal of the article was to identify and evaluate actions taken in this area in Poland. It was achieved by analysing the literature on the subject and statistical data, and conducting induction based on the above-mentioned sources.
Social-health care to oncological elderly patients implies interconnection among oncological hospital and sub-district services and acknowledgement of a sole access channel. The project requires the ...formation of an inter-administrative coordination group and of functional transmural units with evaluational and operative roles. Various care levels (protected hospital admission and discharge, continuity visits, evaluational-therapeutic integration during treatment, palliative cures) implicate specific criterion of elegibility and actions to rationalize organization, coordination and distribution of interventions. Efficiency and effectiveness depend on integration with the services that supply material and with the diagnostic and ambulatory ones. The mid-term prospectives of the integration regard computerization of diagnostic, therapeutic, care and rehabilitation courses of patients (Regional Computerized Register of Disability) and formation of polyfuncitonal centres that concern home, residential and hospital intervention. Powerful technological instruments and the new organizational forms now available should encourage the formation of a morally upright society.
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