The Lancet Regional Health: Western Pacific最新文献

{"title":"Developing institutional policies for health professionals’ education reform: a case study of medical education in Viet Nam","authors":"Quang Cuong Le ,&nbsp;My Hanh Bui ,&nbsp;Quynh Long Khuong ,&nbsp;Phuong Anh Le ,&nbsp;Diep Tuan Tran ,&nbsp;Quoc Huy Nguyen Vu ,&nbsp;Nu Viet Vu","doi":"10.1016/j.lanwpc.2025.101551","DOIUrl":"10.1016/j.lanwpc.2025.101551","url":null,"abstract":"<div><div>The Lancet 2010 Commission for Health Professionals' Education highlighted both instructional and institutional reforms to improve health professionals' training. While developed countries often have well-established policies to facilitate educational reform, such policies are limited in many developing countries, including Viet Nam. In this paper, we outline the development and implementation of three key institutional policies to enhance medical education in Viet Nam: (1) Establishing competency standards for the Medical Doctor (MD) program, (2) coordinating clinical training between medical universities and hospitals, and (3) setting up a national licensing examination. These policies were also evaluated against the Lancet Commission's recommendations. Decisive factors for Viet Nam's initial success include the pioneering mindset of its governmental leaders, close collaborations between academic and governmental institutions, and support from international organizations and experts. This paper may serve as a useful reference for low- and middle-income countries seeking to improve medical education and health professionals' training.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101551"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and inequalities in physical fitness and nutritional status among 0.72 million Chinese adults aged 20–59 years: an analysis of five successive national surveillance surveys, 2000–2020","authors":"Chenyuan Qin ,&nbsp;Chaoqun Fan ,&nbsp;Jingjing Wang ,&nbsp;Qin Li ,&nbsp;Jue Liu ,&nbsp;Haijun Wang ,&nbsp;Qiang Feng","doi":"10.1016/j.lanwpc.2025.101542","DOIUrl":"10.1016/j.lanwpc.2025.101542","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Few comprehensive studies have assessed the long-term trends in physical fitness and nutritional status among Chinese adults, along with the socioeconomic inequalities. This study aimed to bridge this gap by examining the temporal changes and the evolution of socioeconomic disparities in physical fitness and nutritional status among Chinese adults aged 20–59, based on five successive national surveillance surveys.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We integrated data from five consecutive rounds of National Physical Fitness Surveillance (2000, 2005, 2010, 2014, and 2020) among Chinese adults aged 20–59 years. BMI was categorized into underweight (&lt;18.5 kg/m&lt;sup&gt;2&lt;/sup&gt;), overweight (24.0–27.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), and obesity (≥28.0 kg/m&lt;sup&gt;2&lt;/sup&gt;). Central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. A composite physical fitness indicator (PFI) was calculated by aggregating the Z-scores of all six components. Provinces were ranked by GDP per capita ($) and stratified into three socioeconomic strata from least (T1) to most developed (T3). Generalized additive models (GAMs), adjusted for age and sex, were employed to assess the associations between nutritional status, PFI, and both per capita GDP and urbanization levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 716,790 Chinese adults aged 20–59 were included in the analysis. The PFI score declined from 0.71 in 2000 to −0.84 in 2020, with a particularly sharp annual decline between 2014 and 2020. The underweight prevalence declined from 5.54% in 2000 to 3.51% in 2020, while the prevalence of overweight, obesity, and central obesity increased to 35.84%, 15.05%, and 32.10% in 2020, respectively. After 2005, the urban-rural disparities in physical fitness narrowed, whereas the gap between most and least developed regions widened, with urban and high-SES regions consistently showing better fitness. The prevalence of overweight, obesity, and central obesity in urban and economically developed regions was higher than in less economically developed and rural regions in earlier years, but this pattern reversed over time. The underweight prevalence showed the opposite trend. With increasing GDP per capita, PFI initially rose before declining at higher levels, and it showed a positive correlation with urbanization. Overweight prevalence increased with GDP per capita but slowed at higher levels, while obesity and central obesity exhibited an N-shaped relationship with GDP per capita. Moreover, prevalence of overweight, obesity, and central obesity were positively correlated with urbanization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;During the first two decades of the 21st century, China experienced rapid economic growth accompanied by declining physical fitness and rising prevalence of overweight, obesity, and central obesity among adults aged 20–59 years. Inequalities in nutritional status between urban and rural areas and ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101542"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer prevention in the Western Pacific region","authors":"Nehmat Houssami","doi":"10.1016/j.lanwpc.2025.101531","DOIUrl":"10.1016/j.lanwpc.2025.101531","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101531"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy and its racial specificity for breast cancer treatment in Asia: a narrative review","authors":"Rui-Chen Xu ,&nbsp;Yan-Wu Zhang ,&nbsp;Cui-Cui Liu ,&nbsp;Ying-Ying Xu ,&nbsp;Zhi-Ming Shao ,&nbsp;Ke-Da Yu","doi":"10.1016/j.lanwpc.2024.101180","DOIUrl":"10.1016/j.lanwpc.2024.101180","url":null,"abstract":"<div><div>Immunotherapy, including immune checkpoint inhibitors, adoptive cell therapy, cancer vaccines, and other modalities, represents a significant advancement in cancer treatment. Breast cancer, traditionally considered less amenable to immunotherapy, has demonstrated responsiveness to immunotherapy when combined with conventional treatment options. These integrative strategies enhance the effectiveness of immunotherapy, bringing hope to patients. Furthermore, precision therapies guided by predictive biomarkers refine the scope of breast cancer immunotherapy and broaden its advantages. Notably, it is essential to recognise the differences in breast cancer epidemiology, clinical outcomes, and molecular signatures between Asian populations and those in Europe and North America. These include a higher proportion of premenopausal patients and variation in subtype distribution and gene mutation profiles, underscoring the importance of considering racial specificity in immunotherapy. Clinical efforts in Asia, supported by ethnicity-specific studies, indigenous immunotherapeutic agents, and precision medicine informed by predictive biomarkers, provide tailored treatment options. This review aims to present an overview of breast cancer immunotherapy while address the racial specificity to inform its application for Asian patients.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101180"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uplifting ethnic minority voices in the Western Pacific region: a priority for regional suicide research","authors":"Luke T. Bayliss ,&nbsp;Ingrid D. Lui ,&nbsp;Lai Fong Chan ,&nbsp;Shu-Sen Chang ,&nbsp;Tae-Yeon Hwang ,&nbsp;Vanda Scott ,&nbsp;Yasuyuki Shimizu ,&nbsp;Paul S.F. Yip","doi":"10.1016/j.lanwpc.2025.101540","DOIUrl":"10.1016/j.lanwpc.2025.101540","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101540"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of rapid temperature fluctuations on acute stroke risk: a nationwide case-crossover study from 2001 to 2020","authors":"Miku Kono ,&nbsp;Wei-Te Wu ,&nbsp;Chuan-Pin Lee ,&nbsp;Yu-Yin Chang ,&nbsp;Yao-Hsu Yang ,&nbsp;Ching-Chun Lin ,&nbsp;Pau-Chung Chen","doi":"10.1016/j.lanwpc.2025.101546","DOIUrl":"10.1016/j.lanwpc.2025.101546","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Climate factors greatly affect cardiovascular health, with stroke ranking among serious global concerns. However, the impact of rapid temperature fluctuations on stroke risk remains underexplored. Given Taiwan's aging population and the intensifying effects of climate change, understanding influence of ambient temperatures on stroke risk is crucial for public health protection. This study aimed to explore the link between ambient temperature, sudden day-to-day temperature changes, and stroke onset in Taiwan, taking air pollutants into consideration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a time-stratified case-crossover study from 2001 to 2020 using Distributed Lag Nonlinear Models (DLNM) within conditional logistic regression to examine lagged associations between temperature parameters and stroke risk. We analyzed associations separately for total stroke, ischemic stroke, and hemorrhagic stroke to identify potential differences in risk patterns, using odds ratios (ORs) relative to the temperature associated with the lowest stroke risk. Data from the National Health Insurance Research Database (NHIRD) identified the study population, including 1,100,074 first-time stroke emergency events and self-matched with 2,200,148 non-stroke onset dates as controls. The primary exposure assessments included daily temperatures (mean, maximum, and minimum) and temperature fluctuations (diurnal temperature range (DTR), sudden day-to-day temperature increases (TDI), and sudden day-to-day temperature decrease (TDD)), adjusted for air pollutants (PM&lt;sub&gt;2.5&lt;/sub&gt;, O&lt;sub&gt;3&lt;/sub&gt;, SO&lt;sub&gt;2&lt;/sub&gt;, and NO&lt;sub&gt;2&lt;/sub&gt;), and rainfall. Lag periods up to 13 days prior to the corresponding event or control days were used to examine the lag effect of stroke risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Through DLNM exposure-lag-response effect analysis after adjustment for PM&lt;sub&gt;2.5&lt;/sub&gt;, O&lt;sub&gt;3&lt;/sub&gt;, SO&lt;sub&gt;2&lt;/sub&gt;, NO&lt;sub&gt;2&lt;/sub&gt;, and rainfall, the study revealed that when TDI exceeded 6 °C, the risk of ischemic stroke more than doubled compared to the lowest risk temperature (OR: 2.173, 95% CI: 1.887, 2.501). The risk continued to rise until 9 °C, with a second peak observed when TDI exceeded 16 °C (OR: 2.096, 95% CI: 1.733, 2.535). Conversely, TDD exceeding 14 °C was linked to heightened hemorrhagic stroke risk (OR: 2.187, 95% CI: 2.055, 2.326). Additionally, daily maximum temperature exceeding 35 °C was associated with an increased stroke risk, primarily affecting ischemic stroke, while daily minimum temperature below 16 °C was strongly associated with a doubled risk of hemorrhagic stroke.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Our findings indicate that sudden day-to-day temperature increases and decreases are significant predictors of stroke onset. These results emphasize a noteworthy relationship between temperature and stroke risk over consecutive days, supporting interventions aimed at reducing stroke incidence.&lt;/div","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101546"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrality or complacency? Rethinking Singapore’s place in a decolonising global health landscape","authors":"Claire Gabrielle Djuhadi ,&nbsp;Kaisin Yee ,&nbsp;Hiang Khoon Tan","doi":"10.1016/j.lanwpc.2025.101549","DOIUrl":"10.1016/j.lanwpc.2025.101549","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101549"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-month prevalence of DSM-5 mental disorders and the psychosocial correlates- a child and adolescent psychiatric epidemiologic survey in Hong Kong SAR","authors":"Sandra S.M. Chan ,&nbsp;Oscar W.H. Wong ,&nbsp;Samara Hussain ,&nbsp;Kelvin K.F. Tsoi ,&nbsp;Karen K.Y. Ma ,&nbsp;Steven W.H. Chau ,&nbsp;Suk Ling Ma ,&nbsp;Kelly Y.C. Lai ,&nbsp;Winnie C.W. Chu ,&nbsp;Holly H.L. Lo ,&nbsp;Stephy W.S. Ho ,&nbsp;Ching Chi Leung ,&nbsp;Karen K.L. Yiu ,&nbsp;Suzanne H.W. So ,&nbsp;Pak C. Sham ,&nbsp;Se Fong Hung ,&nbsp;Patrick W.L. Leung","doi":"10.1016/j.lanwpc.2025.101533","DOIUrl":"10.1016/j.lanwpc.2025.101533","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Childhood and adolescence, as critically important developmental stages, set the premise for the lifelong trajectory of health and well-being. Epidemiologic evidence abounds in purporting that half of all lifetime mental disorders begin in adolescence. Epidemiologic data based on structured clinical diagnostic assessments are disproportionately scarce in Asian countries that host fast-growing youth population along a wide socioeconomic spectrum in the course of globalisation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A cross-sectional school-based epidemiologic survey was conducted on a representative random sample of children and adolescents aged 6–17 years from September 2019 to June 2023 in Hong Kong Special Administrative Region (Hong Kong SAR). The main diagnostic measures were 31 DSM-5 disorders assessed with Diagnostic Interview Schedule for Children, Version 5 (DISC-5) on the whole study sample. One parent/caregiver of each participant was interviewed for cases from primary schools. Separate parent/caregiver and student interviews were conducted for cases from secondary schools where research diagnoses derived from both sources in the adolescent/caregiver pair were combined at disorder level. A host of developmental and psychosocial factors were also collected. The study sample was reconstituted according to the discrepancy between the study population and official population data (census mid-year 2022 and Education Bureau) in terms of age, sex, ethnicity, household income and school type to give weight-adjusted prevalence estimation of various disorders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The final weighted sample consisted of 6082 participants. The 12-month prevalence of having only one DSM-5 disorder was 13.5% (95% CI: 12.6–14.3%), while the 12-month prevalence of having two or more DSM-5 disorders was 11.0% (95% CI: 10.2–11.8%). The most prevalent disorders/categories of disorders were attention-deficit/hyperactivity disorder (ADHD) (10.2%, 95% CI: 9.4–11.0%); any disruptive, impulse control and conduct disorders (8.8%, CI:8.1–9.5%); any anxiety disorders (6.1%, 95% CI: 5.5–6.7%); any depressive disorders (5.4%, 95% CI: 4.8–6.0%). The 12-month prevalence rates of suicide ideation, plan, and attempt (not including the non-suicidal self-injury) were respectively 3.9% (95% CI: 3.4–4.4%), 1.9% (95% CI: 1.6–2.3%), 1.1% (95% CI: 0.8–1.3%). Parental anxiety and depressive symptoms, any clinically significant sleep disorder, and major school maladjustments (such as repeating a grade, school suspension, absenteeism) were significant factors associated positively (ORs: 1.1–3.37, p-values &lt; 0.01–0.001) with ADHD, externalizing and internalizing disorders in multivariate logistic regressions that account for a multitude of developmental and environmental factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;This study provides the first comprehensive mental health survey on children and adolescents that might inform o","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101533"},"PeriodicalIF":7.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Southeast Asia and the Western Pacific ready for potential monkeypox virus outbreaks?","authors":"Janhavi A ,&nbsp;Gregory Gan ,&nbsp;Akira Endo ,&nbsp;Rayner Kay Jin Tan ,&nbsp;Kiesha Prem ,&nbsp;Borame Lee Dickens","doi":"10.1016/j.lanwpc.2025.101526","DOIUrl":"10.1016/j.lanwpc.2025.101526","url":null,"abstract":"<div><div>The new variant of the monkeypox virus (MPXV) clade Ib has recently spread to other African countries outside the Democratic Republic of the Congo (DRC), prompting the World Health Organisation to declare the outbreak as a public health emergency of international concern (PHEIC). This comes just two years after the initial PHEIC that was issued for the clade IIb outbreaks. Compared to the clade IIb outbreaks, clade Ib shows a demographic shift, including higher case fatality rates for younger individuals, indicating a possibility of additional transmission pathways through heterosexual and household contacts. Given that many countries in the Western Pacific (WPR) and the Southeast Asian region (SEAR) hold a disproportionate burden of endemic infectious diseases and have difficulties engaging key at-risk populations, an outbreak of the potentially more virulent clade Ib virus could have devastating impacts on the health care systems. Thus, strategy planning against the potential emergence of clade Ib MPXV in the regions is required, including surveillance systems for detection, modelling studies to perform risk assessments, implementation of non-pharmaceutical interventions, and vaccination, and regional collaboration to ensure equitable distribution of vaccinations.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101526"},"PeriodicalIF":7.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of surgery in Indigenous people with cancer: a systematic review and meta-analysis","authors":"Saira Sanjida ,&nbsp;Gail Garvey ,&nbsp;Roxanne Bainbridge ,&nbsp;Abbey Diaz ,&nbsp;Federica Barzi ,&nbsp;Sherry Holzapfel ,&nbsp;Michael Y. Chen ,&nbsp;Harry Collin ,&nbsp;Yaqoot Fatima ,&nbsp;Xiang-Yu Hou ,&nbsp;James Ward","doi":"10.1016/j.lanwpc.2025.101527","DOIUrl":"10.1016/j.lanwpc.2025.101527","url":null,"abstract":"<div><h3>Background</h3><div>As cancer incidence increases globally, so does the prevalence of cancer among Indigenous peoples. Indigenous peoples face significant barriers to healthcare, including access to and uptake of surgery. To date, the synthesis of access to and uptake of surgery for Indigenous peoples living with cancer has not yet been reported.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review and meta-analysis of access to and uptake of surgery for Indigenous peoples in Canada, Australia, New Zealand, and the United States. Five databases were searched to identify studies of Indigenous adults with cancer and those who received surgery. The Joanna Briggs Institute critical appraisal tools were used to assess the quality and inclusion of articles. Random effect meta-analyses were conducted to estimate the pooled prevalence of surgery in Indigenous people with cancer.</div></div><div><h3>Findings</h3><div>Of the 52 studies in the systematic review, 38 were included in the meta-analysis. The pooled prevalence of surgery in Indigenous people with cancer was 56.2% (95% confidence interval (CI): 45.4–66.7%), including 42.8% (95% CI: 36.3–49.5%) in the Native Hawaiian population, 44.5% (95% CI: 38.7–50.3%) in the Inuit and 51.5% (95%CI: 36.8–65.9%) in Aboriginal and Torres Strait Islander people. Overall, Indigenous people received marginally less cancer surgery than non-Indigenous people (3%, 95% CI: 0–6%). Indigenous people were 15% (95% CI: 6–23%) less likely to receive surgery than non-Indigenous people for respiratory cancers. Remoteness, travel distance, financial barriers, and long waiting times to receive surgery were factors cited as contributing to lower access to surgery for Indigenous people compared to non-Indigenous people.</div></div><div><h3>Interpretation</h3><div>Efforts to improve access and use of cancer services and surgery for Indigenous peoples should be multilevel to address individual factors, health services and systems, and structural barriers. These determinants need to be addressed to expedite optimal care for Indigenous peoples, especially those living in outer metropolitan areas.</div></div><div><h3>Funding</h3><div>The Research Alliance for <span>Urban Goori Health</span> (RAUGH) funded this project. GG was funded by an <span>NHMRC</span> Investigator Grant (<span><span>#1176651</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101527"},"PeriodicalIF":7.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}