Journal of Cancer Policy最新文献

{"title":"Dose Optimization of Immune Checkpoint Inhibitors: A Policy opportunity to reduce costs and improve access to immunotherapy in the United States.","authors":"Sameer Deshmukh, Arthi Sridhar, Nilansh Kataria, Chelsee J Jensen, Scott A Soefjie, Krishna Sajeev, S M Qasim Hussaini, Daria Chelysheva, Aakash Desai","doi":"10.1016/j.jcpo.2026.100823","DOIUrl":"https://doi.org/10.1016/j.jcpo.2026.100823","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, but are associated with high costs and limited accessibility. Optimizing dosing strategy to achieve a Pharmacokinetics/Pharmacodynamics (PK/PD) supported alternative lower dose (PPALD) that maintains clinical benefit and offers a cost-minimization strategy with substantial health system savings.</p><p><strong>Methods: </strong>We conducted a literature review of Phase 1/2 trials describing the PPALD dose of three commonly used ICIs: Pembrolizumab, Nivolumab and Atezolizumab. Alternate dosing strategies based on data for pembrolizumab (2mg/kg), nivolumab (2mg/kg) and atezolizumab (10mg/kg) were proposed. Public CMS Medicare Part B data on expenditure for these therapies was used to obtain average cost/dose, mg/dose, and number of Medicare beneficiaries between 2018-2021. Costs were calculated based on current FDA approved dosing and alternate dosing strategies.</p><p><strong>Results: </strong>PPALD resulted in substantially lower drug costs per patient for an 80kg individual compared with fixed dosing: pembrolizumab ($7,393.60 vs $9,242.00), nivolumab ($4,153.60 vs $12,460.80), and atezolizumab ($5,744.00 vs $8,616.00). Estimated 2018-2021 Medicare savings based on beneficiaries were $382.2 million for pembrolizumab, $943.1 million for nivolumab, and $114.4 million for atezolizumab, totaling nearly $1.44 billion.</p><p><strong>Conclusion: </strong>Alternate immunotherapy dosing represents a high-value cost saving strategy to reduce health care costs and improve global access. Implementation requires regulatory adaptation, smaller vials, or vial-sharing to minimize waste.</p><p><strong>Policy summary: </strong>This policy analysis demonstrates that evidence-based alternate dosing of commonly used checkpoint inhibitors (Pembrolizumab, Nivolumab and Atezolizumab) could substantially reduce drug expenses while maintaining efficacy. Using Medicare Part B utilization data, we estimated that implementation of these alternative dosing strategies can help save over $1.44 billion between 2018-2021. These findings have important implications for health policy by improving patient access to immunotherapy and curtailing financial toxicity. This can be further facilitated by the support of policymakers, regulatory agencies supporting prospective validation studies and development of reimbursement models that encourage dose optimization.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100823"},"PeriodicalIF":2.2,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekend admission and early in-hospital mortality among patients with hematologic malignancies admitted for febrile neutropenia.","authors":"Tarfa Verinumbe, Ahmad Al-Riyalat, Ariana Neely, Chidiebube Ugwu, Dhriti Sood, Elvis Obomanu, Colton Jones, Basheer U Mohammed, Alejandro Delgado, Zachary Cohn","doi":"10.1016/j.jcpo.2026.100821","DOIUrl":"10.1016/j.jcpo.2026.100821","url":null,"abstract":"<p><strong>Introduction: </strong>Weekend admissions have been associated with worse health outcomes compared with weekday admissions. Our study assessed the association between weekend admission and early in-hospital mortality among patients with hematologic malignancies and febrile neutropenia. We further evaluated whether septic shock mediates this relationship, regardless of length of in-hospital stay.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the 2016-2020 NIS database identifying patients with febrile neutropenia and hematologic malignancies using ICD-10 codes. Weekend admission was the primary exposure, while 3- and 7-day in-hospital mortality were the study outcomes. Generalized linear models estimated the association between weekend admission and each outcome, adjusting for sociodemographic characteristics, comorbidities, cancer type, elective admission status and length of stay.</p><p><strong>Results: </strong>Among 45,540 patients in this study, 57% were male, 65% were white and the mean age was 51 years. Weekend admission was significantly associated with a higher risk of 3-day (RR=1.48; 95%CI: [1.21-1.83]) and 7-day mortality (RR=1.32; 95%CI: [1.12-1.56]). Mediation analysis demonstrated that septic shock significantly mediated the association between weekend admission and overall in-hospital mortality - indirect effect (RR=1.03; 95% CI [1.01-1.04]), whereas the direct effect and overall effect of weekend admission on mortality were not statistically significant.</p><p><strong>Conclusion: </strong>Weekend admission was associated with a higher risk of early in-hospital mortality. Septic shock partially mediated this relationship when assessed across the entire in-hospital stay. The absence of a direct weekend effect suggests that health system-level factors contributing to septic shock may represent key intervention targets to improve mortality outcomes in this high-risk population.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100821"},"PeriodicalIF":2.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Diversity among Medical Cancer Workforce Trainees in the United States over Fifteen years.","authors":"Fernanda M Favorito, Vanessa Freitas Bratti, Wilma Hopman, Narjust Florez, Edward Christopher Dee, Erin Jay G Feliciano, Ahmedin Jemal, Fabio Y de Moraes","doi":"10.1016/j.jcpo.2026.100822","DOIUrl":"https://doi.org/10.1016/j.jcpo.2026.100822","url":null,"abstract":"<p><strong>Purpose: </strong>Diverse oncology workforces improve care quality, patient satisfaction, and outcomes, particularly among underserved populations. This study aimed to evaluate long-term demographic and educational trends among U.S. cancer-related medical trainees and examine how these trends have shifted across specialties over a 15-year period.</p><p><strong>Materials and methods: </strong>Publicly available data were sourced from the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books. Gender and educational-background trends were evaluated from 2007-2023, while race/ethnicity trends were evaluated from 2011-2023 across cancer-related physician training programs, including hematology-medical oncology, medical oncology, radiation oncology, surgical oncology, pediatric hematology-oncology, medical genetics, pathology, diagnostic and interventional radiology, and nuclear medicine. Demographic variables included gender, race/ethnicity, and age; educational background was categorized as U.S. allopathic, U.S. osteopathic, or international medical graduate (IMG). Trends were assessed using the nonparametric Mann-Kendall test, with P<.05 indicating statistical significance.</p><p><strong>Results: </strong>Between 2007 and 2023, female trainee representation rose significantly (47.0% to 51.5%; p<0.001), with notable gains in pediatric hematology-oncology and medical oncology. Hispanic/Latino representation increased significantly from 7.9% to 11.6% overall (p<0.001), while African American/Black representation remained unchanged (7.1% to 7.5%; p>0.05). Asian/Pacific Islander proportions rose in select specialties. The percentage of U.S. osteopathic graduates increased across most specialties (5.1% to 16.2%; p<0.001), whereas IMG representation declined slightly overall. U.S. allopathic representation decreased from 62.9% to 53.3% (p<0.001), with variation across specialties.</p><p><strong>Conclusion: </strong>While gains in gender and Hispanic/Latino representation are evident, African American/Black trainee representation remains stagnant, and changes in IMG participation vary across specialties. These diverging trends highlight persistent representation gaps within the U.S. cancer workforce training pipeline. Continued monitoring will be important to determine how evolving educational and accreditation policies influence these trends over time.</p><p><strong>Policy summary: </strong>Based on these findings, program directors and professional societies should maintain inclusive recruitment practices and continue systematic monitoring of workforce diversity as accreditation policies evolve. Sustained institutional commitment may help preserve patient trust, address workforce needs, and support an oncology workforce that better reflects the populations it serves.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100822"},"PeriodicalIF":2.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges of Cancer Registries in Nigeria: Contemporary Approaches and Solutions.","authors":"O A Ajagbe, T A Olagunju, P A Ekhaiyeme, O E Dada, K Onah","doi":"10.1016/j.jcpo.2026.100815","DOIUrl":"https://doi.org/10.1016/j.jcpo.2026.100815","url":null,"abstract":"<p><p>Cancer registries are the cornerstone of population level cancer surveillance, providing the data necessary to estimate burden, monitor trends, and evaluate cancer control programmes. In low- and middle-income countries (LMICs) like Nigeria, these registries face overwhelming challenges, including limited geographic coverage, poor data acquisition, inadequate infrastructure, and constrained workforce capacity, all of which undermine data quality at a time of a looming cancer burden. This review assesses the current state of Nigerian registries, spearheaded by the pioneer University College Hospital (UCH), Ibadan registry, established in 1962, and examines the landscape of artificial intelligence (AI) applications that can transform operations through automated data abstraction, improved record linkage, and real time surveillance. Using a narrative synthesis of published literature and international guidelines, the review finds that while AI models such as machine learning and natural language processing show great promise for enhancing efficiency, fragmented health information systems, limited digitization, and weak governance frameworks hinder their deployment in LMICs. Strengthening these systems requires a dual strategy of structural reform and phased technological innovation. Policy level interventions, including legal mandates for registration, sustainable domestic financing, and appropriate AI governance, are essential to transform passive data repositories into intelligent surveillance systems and ensure equitable improvements in cancer control across Nigeria and comparable settings.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100815"},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Governing AI in radiotherapy: Ensuring automation supports rather than substitutes for workforce expertise.","authors":"Nipun Gorantla, Edward Christopher Dee, Fabio Ynoe Moraes","doi":"10.1016/j.jcpo.2026.100814","DOIUrl":"10.1016/j.jcpo.2026.100814","url":null,"abstract":"<p><p>Radiotherapy (RT) is required for approximately half of all patients with cancer, yet global access remains profoundly unequal, particularly in low- and middle-income countries (LMICs), where workforce growth has failed to keep pace with rising cancer incidence, and most who require RT do not receive it. Artificial intelligence (AI) is increasingly framed as a solution to this gap, with automation promoted to \"leapfrog\" workforce shortages by accelerating contouring, treatment planning, and quality assurance. We argue that explicit governance and workforce safeguards are needed to complement AI proliferation, to mitigate risks of overreliance on automation and reduced opportunities for clinical expertise development. Diffusion optimism (the assumption that introducing AI into RT workflows will automatically yield safe, scalable clinical capacity) and its companion, validation optimism (the assumption that regulatory clearance implies safety across diverse clinical contexts) rest on the premise that deployment will generate efficient clinical capacity by default. In RT, this premise is difficult to separate from the formation and preservation of expertise. Without governance, accountability, and training safeguards, AI not only introduces technical risk but reshapes clinical authority in ways that can perpetuate algorithmic dependency and reduce opportunities to develop clinical expertise. We therefore argue that AI must be governed as a capacity-shaping technology, prioritizing how expertise is formed, exercised, and preserved, rather than as an outright capacity substitute.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100814"},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction notice to “Evidence on vaping e-cigarettes as a risk factor for cancer: A systematic review” [J. Cancer Policy 45C (2025) 100615]","authors":"Guilherme Guedes de Oliveira ,&nbsp;Rebeca Milka Lemos Magalhães Liberato ,&nbsp;Amaxsell Thiago Barros de Souza ,&nbsp;Ayane Cristine Alves Sarmento ,&nbsp;Edilmar de Moura Santos ,&nbsp;Kleyton Santos de Medeiros ,&nbsp;Irami Araújo Filho","doi":"10.1016/j.jcpo.2026.100734","DOIUrl":"10.1016/j.jcpo.2026.100734","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"48 ","pages":"Article 100734"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-Based Cancer Screening analysis in Northern Portugal Using Process Mining","authors":"Hugo Monteiro ,&nbsp;Mariana Oliveira ,&nbsp;Ricardo Martinho ,&nbsp;João Reis ,&nbsp;Fernando Tavares ,&nbsp;Óscar Felgueiras ,&nbsp;Carlos Martins","doi":"10.1016/j.jcpo.2026.100702","DOIUrl":"10.1016/j.jcpo.2026.100702","url":null,"abstract":"<div><h3>Background</h3><div>This study focuses on the Colorectal Cancer Screening Program in Northern Portugal, aiming to evaluate the disruption effects on its performance and efficiency.</div></div><div><h3>Methods</h3><div>We conducted an observational analyses of 271 637 administrative records from 2020 to 2022. Administrative timestamps were converted into a step-by-step dataset of screening activities (an “event log”) and analysed using process mining and comparative performance analysis across time periods and ACeS (primary care administrative clusters).</div></div><div><h3>Results</h3><div>Consultation‑to‑colonoscopy time lengthened by 53 %, rising from a median 58 days (IQR 29–92) in early 2020 to 89 days (IQR 53–127) in 2021, before improving to 73 days in 2022. Conversely, referral‑to‑consultation time fell from 110 days to 26 days (−76 %), reflecting targeted backlog clearance. Screening volumes declined in 2020 but recovered above baseline levels by 2022. Performance differences across primary care administrative clusters were significant (p &lt; 0.001), with some units outperforming regional median transition times. Early adoption of automated electronic referrals and flexible consultation scheduling may have contributed to improved programme performance during the recovery period following pandemic-related disruptions. Substantial heterogeneity across units was observed for key transitions, indicating uneven disruption and recovery patterns across administrative units.</div></div><div><h3>Conclusion</h3><div>Process Mining techniques revealed critical vulnerabilities in the screening program during the initial stages of the period in analysis (matching the pandemic). These findings support targeted monitoring and prioritisation of operational improvements to reduce avoidable delays and strengthen continuity of population-based screening.</div></div><div><h3>Policy summary</h3><div>Policies aimed at strengthening healthcare service continuity and operational capacity benefit from analytical methods like process mining. Key recommendations include standardizing workflows, enhancing coordination between primary care and hospital services, and investing in digital monitoring systems to mitigate disruptions and ensure continuity in cancer screening programs during periods of system stress.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100702"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the role and competencies of the medical oncologist in diagnostic and therapeutic care pathways: Consensus recommendations from the Italian association of medical oncology (AIOM)","authors":"Rossana Berardi ,&nbsp;Francesca Rossi ,&nbsp;Valentina Tarantino ,&nbsp;Michele De Tursi ,&nbsp;Angelo Dinota ,&nbsp;Giancarlo Di Pinto ,&nbsp;Roberto Bianco ,&nbsp;Francesco Leonardi ,&nbsp;Alessandra Bearz ,&nbsp;Alessandra Fabi ,&nbsp;Alessandro Pastorino ,&nbsp;Franco Nolè ,&nbsp;Paolo Alessandroni ,&nbsp;Francesco Carrozza ,&nbsp;Lucio Buffoni ,&nbsp;Tiziana Latiano ,&nbsp;Daniele Farci ,&nbsp;Massimiliano Spada ,&nbsp;Carmelo Bengala ,&nbsp;Stefania Kinspergher ,&nbsp;Roberto Papa","doi":"10.1016/j.jcpo.2026.100701","DOIUrl":"10.1016/j.jcpo.2026.100701","url":null,"abstract":"<div><h3>Background</h3><div>Diagnostic and Therapeutic Care Pathways (DTCPs) are clinical governance tools aimed at managing the care of specific patient populations through the coordinated application of standardized, evidence-based interventions by multidisciplinary teams. Their primary goal is to ensure equitable, timely, and cost-effective access to high-quality care.</div></div><div><h3>Materials and method</h3><div>A panel of recognized opinion leaders, endorsed by the Italian Association of Medical Oncology (AIOM), was convened to develop a consensus document defining the role of the medical oncologist within Multidisciplinary Oncology Groups (MOGs) and DTCPs. Employing the RAND/UCLA Appropriateness Method in its “consensus conference” format, the panel evaluated a series of statements derived from a review of the scientific literature and expert-generated Good Practice Points (GPPs). These statements addressed five key areas.<ul><li><span>1.</span><span><div>Skills of the Oncologist in the diagnostic phase</div></span></li></ul></div><div><ul><li><span>2.</span><span><div>Follow up</div></span></li></ul><ul><li><span>3.</span><span><div>Palliative care</div></span></li></ul></div><div><ul><li><span>4.</span><span><div>Management of the diagnostic and therapeutic care pathway of the oncological patient</div></span></li></ul><ul><li><span>5.</span><span><div>Medical therapy.</div></span></li></ul></div><div>To further support each topic, illustrative case studies were presented.</div></div><div><h3>Results</h3><div>A total of 21 articles met the inclusion criteria, yielding 88 evidence-based recommendations. Additionally, panel members contributed 9 further GPPs based on clinical expertise. Of the 97 total recommendations, 95 received a relevance score above 7, while 2 scored between 4 and 6.9; none scored below 4.</div></div><div><h3>Conclusions</h3><div>This consensus effort and the resulting document represent a comprehensive evaluation of the available evidence regarding the role of medical oncologists within MOGs and DTCPs. The objective is to propose standardized criteria for the optimal management of cancer patients (pts) across all phases of care from initial diagnosis and staging to treatment, follow-up, and end-of-life support.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100701"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient mortality and failure to rescue in lung cancer patients by hospital certification status: Cross-sectional analysis of nationwide german discharge data 2014–2023","authors":"Leonie Meyer ,&nbsp;Christoph Kowalski ,&nbsp;Martin Utzig ,&nbsp;Philipp Hengel","doi":"10.1016/j.jcpo.2026.100715","DOIUrl":"10.1016/j.jcpo.2026.100715","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer-related mortality in Germany. Certification of lung cancer centers aims to improve quality of care primarily by adhering to evidence-based guidelines and minimum case volume requirements. However, the number of procedures is also a part of nationwide requirements. This study examines the association between certification status and outcomes for lung cancer patients undergoing anatomical lung resections in Germany between 2014 and 2023 while adjusting for hospital case volume (based on lung cancer resections) and patient characteristics.</div></div><div><h3>Methods</h3><div>Nationwide Diagnosis-Related Groups data were linked with certification data from the German Cancer Society. Generalized logit regression models adjusted for age, sex, comorbidities, and hospital case volume were used to estimate in-hospital mortality and failure to rescue rates along with the corresponding 95 % confidence intervals. For each year, two separate analyses were conducted: one adjusting for patient characteristics only, and another additionally adjusting for hospital caseload.</div></div><div><h3>Results</h3><div>Adjusted analyses showed a trend of lower in-hospital mortality and failure to rescue rates in certified centers, both with and without adjustment for hospital case volume. However, statistical significance was observed only in the years 2020 and 2021, and only when case volume per hospital was not included as a covariate.</div></div><div><h3>Conclusion</h3><div>While certified centers demonstrated lower in-hospital mortality and failure to rescue rates in specific years, including hospital case volume as a covariate reduced the magnitude of the differences between certified and non-certified hospitals. These results suggest that certification status and hospital case volume interact in complex ways, underscoring the need for further investigation into their independent and combined effects on patient outcomes.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100715"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement initiatives on colposcopy and treatment of cervical pre-cancer services in Bhutan: Experiences, challenges, and way forward","authors":"Namkha Dorji,&nbsp;Thinley Dorji,&nbsp;Yeshey Dorjey,&nbsp;Yangdon Yangdon","doi":"10.1016/j.jcpo.2025.100676","DOIUrl":"10.1016/j.jcpo.2025.100676","url":null,"abstract":"<div><div>Bhutan has achieved 90–70–90 global targets by 2023, way ahead of the global targets of elimination of cervical cancer by 2030. However, cervical cancer remains the most prevalent cancer, among women in Bhutan. While all healthcare screening, diagnosis and treatment of cervical cancers are provided free of cost, sustainability in terms of financing and human resources and ensuring quality of services are the major challenges. Development of a national standard guideline is a major intervention towards improving the quality of colposcopy services and treatment of precancer in the country. In this article, we discuss the summary of the consensus-based practical guideline on colposcopy and treatment of cervical pre-cancers in Bhutan, challenges faced and potential way forward.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100676"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}