Journal of Cancer Policy最新文献

{"title":"Budget impact analysis of treatment-free remission in chronic myeloid leukemia patients treated with nilotinib in Tunisia","authors":"Aziz Hizem ,&nbsp;Manel Keskes ,&nbsp;Hajer Felfel","doi":"10.1016/j.jcpo.2025.100613","DOIUrl":"10.1016/j.jcpo.2025.100613","url":null,"abstract":"<div><h3>Background</h3><div>The emergence of treatment-free remission marks a significant shift in clinical management for chronic myeloid leukemia patients. It involves the discontinuation of tyrosine kinase inhibitors therapy while maintaining a sustained molecular response. In light of this, the study aims to evaluate the budget impact associated with this healthcare strategy among tunisian patients treated with nilotinib. This economic evaluation seeks to provide insights into the affordability of implementing treatment-free remission from the perspective of the Tunisian National Health Insurance Fund.</div></div><div><h3>Methods</h3><div>Over a three-year time horizon, a Markov model assessed the introduction of treatment-free remission in an eligible population. The input data used for transition probabilities and identification of the target population were obtained from a systematic literature review. The economic evaluation considered only the drug acquisition cost as the direct cost covered by the public payer. To account for the variability of results, a one-way deterministic sensitivity analysis was conducted by varying key model parameters.</div></div><div><h3>Results</h3><div>From an initial cohort of 32 eligible patients within the health insurance database, the model estimated the evolution of the target population to 230 patients after three years. The introduction of treatment-free remission as a new strategy in the management of chronic myeloid leukemia would result in a cost-saving estimated at 23.4 million Tunisian Dinars. The uncertainty analysis revealed the significant impact of drug prices on the overall outcomes.</div></div><div><h3>Conclusion</h3><div>This study provides transparent and interpretable results for decision-makers. The economic evaluation reveals a financial gain that can be allocated to address other health priorities within the Tunisian National Health Insurance Fund’s budget.</div></div><div><h3>Policy summary</h3><div>The budget impact analysis advocates for implementing treatment-free remission as a cost-saving intervention for the Tunisian National Health Insurance Fund’s budget.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100613"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579875","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":"Memory, merit, and the machinery of silence: Reconstructing integrity in systems that do not disclose","authors":"Arif Hakan Önder","doi":"10.1016/j.jcpo.2025.100617","DOIUrl":"10.1016/j.jcpo.2025.100617","url":null,"abstract":"<div><h3>Background</h3><div>Financial conflicts of interest (FCOI) are not always visible through misconduct they often operate through omission, invisibility, and routine repetition, often through unexamined speaking roles or symbolic visibility. In healthcare systems lacking formal disclosure mechanisms or institutional memory, FCOI are less an exception and more a design feature, distributing academic visibility and symbolic authority disproportionately.</div></div><div><h3>Objective</h3><div>This perspective aims to critically analyze how the absence of systemic transparency in certain medical environments including transitional or under-regulated systems such as Turkey facilitates a reputational economy where authority is constructed through repetition rather than scholarly merit.</div></div><div><h3>Methods</h3><div>Drawing on conceptual parallels with existing international disclosure models (Open Payments, EFPIA Code), this essay contrasts systems of declared, searchable FCOI with those where neither institutional structure nor academic culture demand accountability. Using Turkey’s oncology field as a case-in-point, it demonstrates how visible engagement can obscure epistemic contribution (i.e., the actual production of original scientific knowledge) and suppress structural reform.</div></div><div><h3>Results</h3><div>In systems where authorship does not shape clinical influence or academic appointment, FCOI becomes embedded in symbolic practices: recurrent speaking roles, unexamined moderator positions, and honoraria-driven visibility. These patterns normalize a closed loop of validation, where symbolic authority reproduces itself and resists self-correction.</div></div><div><h3>Conclusion</h3><div>Restoring integrity requires more than individual virtue it demands institutional tools that remember what systems have ignored. Transparency must be procedural, not performative. Ethics must evolve into structure. Conflict cannot be managed if it cannot be mapped. Only then can ethics move from aspiration to architecture. In systems that forget, memory must be rebuilt as an instrument of reform.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100617"},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557629","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":"Implementing patient reported outcomes in cancer care: Lessons and strategies from a large UK Cancer Centre","authors":"CL. Moss ,&nbsp;J. Malpass ,&nbsp;L. Fox ,&nbsp;T. Guerrero-Urbano ,&nbsp;A. Aggarwal ,&nbsp;M. Van Hemelrijck","doi":"10.1016/j.jcpo.2025.100618","DOIUrl":"10.1016/j.jcpo.2025.100618","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patient-reported outcome measures (PROMs) are valuable for advancing patient-centred cancer care by capturing patients’ views on their health, quality of life, and symptoms. However, routine PROM collection remains difficult to implement in clinical settings. This study evaluated a PROM pilot in the prostate cancer radiotherapy setting at Guy’s Cancer Centre, identifying multi-level barriers and facilitators to routine implementation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A mixed-methods design was used, comprising qualitative interviews with healthcare professionals and a quantitative questionnaire for patients. The interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). Fourteen healthcare professionals (including clinicians, radiographers, and managers) took part in interviews, and ten of twenty prostate cancer patients completed the evaluative questionnaire.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Key patient-level challenges included digital literacy gaps, limited access to technology, and low understanding of PROMs. Provider-level barriers involved limited PROM training, staff turnover, and concerns about added workload. Administrative issues included funding limitations and logistical complexity across multiple care sites. System-level barriers centred on poor integration between PROM platforms and electronic health record (EHR) systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;To support sustainable and scalable PROM use, several strategies are proposed: developing patient education tools, setting thresholds for clinically meaningful PROM changes, appointing administrative staff to reduce provider burden, and offering PROM access via devices such as iPads in waiting rooms. Policy recommendations include resourcing PROM-dedicated staff, enabling flexible training for clinical teams, and introducing support mechanisms to reduce inequities in PROM completion. These approaches aim to embed PROMs into routine cancer care, improving clinical outcomes and patient engagement. Future work should explore the scalability of these strategies across other tumour types and settings, ensuring PROMs can inform value-based, equitable cancer care delivery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Policy summary&lt;/h3&gt;&lt;div&gt;This paper seeks to influence policies that promote patient-centred care in oncology, particularly by enhancing the routine collection and integration of PROMs within cancer treatment pathways. It advocates for policies that allocate resources to support sustainable PROM collection, including dedicated staff roles, infrastructure for technological integration, and patient education resources. Additionally, it highlights the need for policy improvements that address health inequities by providing targeted support for populations facing digital literacy and accessibility challenges. By addressing these policy areas, the paper aims to advance frameworks that improve patient engagement, data-informed c","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100618"},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557628","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":"Estimating the burden of cancer attributable to tobacco in Bangladesh in 2020.","authors":"Giulia Collatuzzo, Sarah Abe, Md Shafiur Rahman, Rokshana Parvin, Manami Inoue, Paolo Boffetta","doi":"10.1016/j.jcpo.2025.100614","DOIUrl":"https://doi.org/10.1016/j.jcpo.2025.100614","url":null,"abstract":"<p><strong>Background: </strong>Information on the attributable fraction (AF) of cancer in Bangladesh is scarce. We aimed at estimating the AF of tobacco-related cancer in Bangladesh in 2020.</p><p><strong>Methods: </strong>Data on prevalence of tobacco use (smokeless, smoking products, and second-hand smoke [SHS]) were derived from the Global Adult Tobacco Survey report (2009), while data on relative risks were derived from meta-analyses and large-scale Indian studies. The GLOBOCAN 2020 database was used to obtain the number of cancer cases and deaths. Concomitant use of both tobacco products was accounted for. Sex-specific and combined estimates were calculated, based on the counterfactual scenario of no exposure to tobacco.</p><p><strong>Results: </strong>Smokeless tobacco was primarily responsible for oral (55.3%), esophageal (37.1%), laryngeal (33.4%) and pharyngeal (31.5%) cancer. Cigarette smoking was responsible mainly for esophageal (40.1%), pancreatic (34.2%) and lung (26.0%) cancer, while bidi caused mainly pharyngeal (49.2%), laryngeal (36.4%) and esophageal (33.3%) cancer. Overall, smokeless tobacco caused 14.6% of cases and 15.1% of deaths, while cigarette smoking caused 11.8% of cases and 15.3% of deaths and bidi smoking 14.1% of cases and 15.8% of deaths. SHS caused 0.6% and 0.8% of cases and deaths respectively. The combined use of tobacco products particularly contributed to esophageal and pancreatic cancers.</p><p><strong>Conclusions: </strong>Tobacco was a major cause of cancer in Bangladesh in 2020, with smokeless and bidi smoking overcoming cigarette's contribution. Its control would greatly reduce cancer burden.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100614"},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576584","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":"Exploring the association between women autonomy and the uptake of breast cancer screening in Ghana","authors":"Sulemana Ansumah Saaka ,&nbsp;Roger Antabe ,&nbsp;Daniel Amoak ,&nbsp;Mildred Naamwintome Molle ,&nbsp;Lina Adeetuk","doi":"10.1016/j.jcpo.2025.100611","DOIUrl":"10.1016/j.jcpo.2025.100611","url":null,"abstract":"<div><h3>Background</h3><div>Breast Cancer (BC) is a leading cause of cancer-related deaths among women, yet the uptake of BC screening exercises remains low, particularly in patriarchal settings of Sub-Saharan Africa (SSA), including Ghana, where women report lower decision-making autonomy regarding their own health. Despite the urgency of this issue, there is a notable lack of research in the Ghanaian context on how women's autonomy affects their engagement in BC screening.</div></div><div><h3>Methods</h3><div>Utilizing data from the 2022 Ghana Demographic and Health Survey (GDHS) (N = 15,014 women), and employing logistic regression models, this study fills the scholarly gap and contributes to the existing literature by examining the association between women’s decision-making autonomy and the uptake of BC screening in Ghana.</div></div><div><h3>Results</h3><div>Women with greater decision-making autonomy (OR=1.169; p &lt; 0.001), the employed (OR=1.186; p &lt; 0.001), owners of valid health insurance cards (OR=1.185; p &lt; 0.01), those who had proximity to health facilities (OR=1.170; p &lt; 0.01), visited health facility in the preceding 12 months (OR=1.351; p &lt; 0.001), and listened to radio at least once in a week (OR=1.486, p &lt; 0.001), were all significantly more associated with BC screening. On the contrary, rural residents (OR=0.874; p &lt; 0.05), traditional religious believers (OR=0.538; p &lt; 0.05), all significantly reported lower odds of BC screening. More so, education, age, ethnicity, household wealth, and region of residence significantly predicted BC screening in the study context.</div></div><div><h3>Conclusion</h3><div>Preventive healthcare policies like BC screening must pay critical attention to women with less educational attainment or from poor socio-economic backgrounds who may lack autonomy regarding their own health.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100611"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548850","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":"“That’s our culture…”: Understanding cervical cancer stigma through Caribbean voices","authors":"Kamilah Thomas-Purcell ,&nbsp;Diadrey-Anne Sealy ,&nbsp;Donrie Purcell ,&nbsp;Christine Richards ,&nbsp;Althea Bailey ,&nbsp;Gaole Song ,&nbsp;Kimlin Ashing","doi":"10.1016/j.jcpo.2025.100609","DOIUrl":"10.1016/j.jcpo.2025.100609","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cervical cancer remains a major public health concern in the Caribbean, where cultural beliefs, stigma, and healthcare barriers hinder prevention and early detection. While stigma has been recognized as a barrier globally, few studies have qualitatively examined how cervical cancer stigma is constructed and experienced within Caribbean cultural contexts. This study uniquely explores the intersecting social and cultural factors influencing cervical cancer-related stigma, screening behaviors, and HPV vaccination in Grenada, Jamaica, and Trinidad and Tobago, filling a critical research gap in understanding stigma beyond patient populations and across national settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A qualitative study was conducted using nine focus groups with 69 participants (54 women, 15 men) recruited from community organizations, health centers, and cancer support networks. Semi-structured interviews explored perceptions of cervical cancer, its causes, screening, and healthcare experiences. Thematic analysis identified key patterns in stigma and barriers to prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Six major themes emerged: (1) Cancer-related stigma and fear, with fatalistic views of cancer as a death sentence; (2) Cultural beliefs, including associations between cervical cancer, promiscuity, and divine punishment; (3) Knowledge gaps and misinformation, contributing to screening and vaccine hesitancy; (4) Gender and societal expectations, reinforcing stigma and discouraging health-seeking behaviors; (5) Health system challenges, such as healthcare mistrust, confidentiality concerns, and financial constraints; and (6) Family history concerns, where secrecy surrounding cancer within families limited awareness and early detection.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Women in low-income settings faced compounded barriers due to gendered norms, limited education, and economic constraints. Healthcare confidentiality concerns further discouraged prevention. Addressing these challenges requires culturally tailored public health campaigns, stronger confidentiality protections, and expanded access to affordable screening and treatment. A regionally coordinated approach to HPV vaccination and cervical cancer prevention is needed to reduce stigma and improve equitable access to care across the Caribbean.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Policy summary&lt;/h3&gt;&lt;div&gt;This study identifies key policy gaps in cervical cancer prevention and HPV vaccination. Findings highlight the need for improved confidentiality protections, enhanced healthcare system trust, and culturally relevant public health interventions to combat stigma and misinformation. Policies should also increase financial access to screening and promote family health communication to improve awareness of hereditary cancer risks. Addressing these gaps can reduce stigma, increase screening and vaccination uptake, and improve cervical cancer outcomes across the region.&lt;/di","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100609"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498274","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":"Implementation and evaluation of a Project ECHO for national cancer control plan implementation in low- and middle-income countries","authors":"Linsey Eldridge ,&nbsp;Mishka Kohli Cira ,&nbsp;Kalina Duncan ,&nbsp;Leslie Given ,&nbsp;Lewis Foxhall ,&nbsp;Darya Kizub ,&nbsp;Clayton Richards ,&nbsp;Karin Hohman","doi":"10.1016/j.jcpo.2025.100610","DOIUrl":"10.1016/j.jcpo.2025.100610","url":null,"abstract":"<div><h3>Background</h3><div>The International Cancer Control Partnership (ICCP) ECHO uses a technology-enabled learning model for knowledge exchange on National Cancer Control Plans (NCCP) implementation strategies for low- and middle-income countries. We evaluated the use of this platform to bring together Ministry of Health-led, transdisciplinary teams in monthly, one-hour sessions with experts and peer presentations between 2020 and 2023.</div></div><div><h3>Methods</h3><div>A pre-post mixed-methods design was used. Baseline and endpoint surveys (41/90, 46 %) measured changes in self-reported knowledge and confidence related to 12 strategies for NCCP implementation based on a four-point Likert scale. Comparisons were done using a paired T-test. Seven post-focus group discussions (FGDs) (6/12 countries, 50 %) captured the perceived utility of ECHO for implementing NCCP priorities. FGDs were audio-recorded, transcribed, double-coded, and underwent thematic analysis.</div></div><div><h3>Results</h3><div>Respondents reported high satisfaction with the curriculum, presentations, and format of the program; however, internet connectivity was a challenge, and duration was identified as an area for improvement. Average self-reported knowledge of and confidence using all 12 strategies increased significantly between pre- and post-surveys (p &lt; 0.0001). Along with expert presentation, the peer-to-peer learning through case-based discussion enhanced their learning experience and ensured that the content was relevant. Some participants recommended incorporating additional one-on-one technical assistance during the program.</div></div><div><h3>Conclusion</h3><div>Study findings suggest this interactive, bidirectional knowledge exchange approach can be effective for improving knowledge and capacity for non-clinical, system-focused areas such as cancer control planning and policy implementation. Further study is warranted to understand how cancer planners utilize their learnings.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100610"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330819","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":"A multidisciplinary approach to strengthening patient navigation among gynaecologic malignancy patients at the Cancer Diseases Hospital in Zambia","authors":"Mupeta Songwe ,&nbsp;Dorothy Lombe ,&nbsp;Susan Msadabwe ,&nbsp;Mukatimui Munalula ,&nbsp;Paul Kamfwa ,&nbsp;Swali Fundafunda ,&nbsp;Emily Walubita ,&nbsp;Samson Chisele ,&nbsp;Victor Mudenda ,&nbsp;Mulindi Mwanahamuntu ,&nbsp;Groesbeck Parham ,&nbsp;Krista S. Pfaendler","doi":"10.1016/j.jcpo.2025.100608","DOIUrl":"10.1016/j.jcpo.2025.100608","url":null,"abstract":"<div><h3>Background</h3><div>Zambia has the third highest incidence of cervical cancer in the world. Patients with gynecological malignancy self-navigate by transmitting referral letters from practitioner to practitioner across different health levels and geographic localities. Specialized oncology services for women with gynecological malignancies are shared between two tertiary hospitals in the capital city: the Cancer Diseases Hospital and the Women and Newborn Hospital.</div></div><div><h3>Methods</h3><div>In 2020, a two-day gynecological malignancies multidisciplinary tumor board workshop targeted clinical oncologists, surgical oncologists, radiologists, pathologists, medical social workers, and nursing and palliative care practitioners. It aimed at harmonizing the functions, goals, and benefits of a multidisciplinary approach to patient navigation and cancer care.</div></div><div><h3>Results</h3><div>Eleven participants from the six specialties attended the workshop. More than 70 % of the workshop participants have consistently attended the weekly virtual gynecological malignancies multidisciplinary tumor board meetings. Attendance of these meetings has expanded from practitioners within the capital Lusaka to other practitioners from all the nation's ten provinces. A virtual referral platform and patient dashboard were created. These platforms have improved the navigation of patients through the system via enhanced communication among practitioners.</div></div><div><h3>Conclusion</h3><div>Patient navigation through a multidisciplinary approach in a low-middle-income country is feasible. Further quantitative work is required to establish how this intervention has improved patient care and clinical research efforts for women with gynecological malignancies in Zambia.</div></div><div><h3>Policy summary</h3><div>Health service leaders in low-middle-income countries need to re-examine the workforce and financing to determine how navigation support can be implemented across the cancer care continuum.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100608"},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303064","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":"Continued tobacco use beyond cancer diagnosis in India – A systematic review and meta-analysis","authors":"Vishnu Rajan ,&nbsp;Sreelakshmi Muralikrishnan ,&nbsp;Bharathnag Nagappa ,&nbsp;Yamini Marimuthu ,&nbsp;Viji Ramachandran ,&nbsp;Aravind Palaniappan","doi":"10.1016/j.jcpo.2025.100605","DOIUrl":"10.1016/j.jcpo.2025.100605","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco use is a leading preventable cause of cancer-related mortality, with significant implications for treatment outcomes and survival. In India, where 28.6 % of adults use tobacco, continued use after cancer diagnosis remains a major public health concern. This systematic review and meta-analysis aimed to estimate the pooled prevalence of continued tobacco use among cancer patients in India.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of observational studies reporting on continued tobacco use post-cancer diagnosis in India. A systematic search of PubMed, Scopus, and Google Scholar yielded 20 observational studies. Eligible studies included adult cancer patients (≥18 years) and reported prevalence of smoking, smokeless tobacco, or both after diagnosis. Data extraction and quality appraisal were performed independently by authors. A random-effects model was used to compute pooled prevalence estimates. Heterogeneity and publication bias were assessed using the I² statistic and Egger’s test, respectively.</div></div><div><h3>Results</h3><div>Twenty studies comprising 75,145 participants were included. The pooled prevalence of continued tobacco use post-diagnosis was 74 % (95 % CI: 59–84 %). Subgroup analysis showed a prevalence of 50 % (95 % CI: 39–62 %) for smoking and 34 % (95 % CI: 26–42 %) for smokeless tobacco. Substantial heterogeneity was observed across studies (I² &gt; 95 %). Evidence of publication bias was present for smoking but not for smokeless tobacco use.</div></div><div><h3>Conclusion</h3><div>Continued tobacco use among Indian cancer patients is alarmingly high, highlighting the urgent need for tobacco cessation interventions within oncology care.</div></div><div><h3>Policy summary</h3><div>The high prevalence of continued tobacco use among cancer patients in India underscores the need for national health policy to mandate routine tobacco use screening and cessation support. Integrating cessation services into cancer care can improve treatment outcomes, reduce recurrence, and lower overall healthcare costs in oncology settings.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100605"},"PeriodicalIF":2.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231567","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 time to withdrawal and full approval of accelerated approval cancer drug indications (1992–2024)","authors":"Kristina Jenei ,&nbsp;Georg Hahn ,&nbsp;Aaron S. Kesselheim ,&nbsp;Ariadna Tibau","doi":"10.1016/j.jcpo.2025.100597","DOIUrl":"10.1016/j.jcpo.2025.100597","url":null,"abstract":"<div><div>The US Food and Drug Administration (FDA) accelerated approval program facilitates earlier access to therapies for serious illnesses based on surrogate endpoints reasonably likely to predict clinical benefit. To minimize risk, sponsors are required to conduct post marketing studies to confirm the benefit. Over the past decade, concerns have emerged about the pace and quality of post marketing evidence generation. We analyzed regulatory outcomes of oncology indications granted accelerated approval between 1992 and 2024, using publicly available FDA data. Median time to conversion to regular approval decreased from 4.3 to 2.3 years and time to withdrawal decreased from 9.5 to 3.2 years between the 1992–2013 and 2014–2024 periods (both p &lt; 0.001). The proportion of indications with confirmatory studies underway at the time of accelerated approval increased from 63 % to 85 % (p = 0.003). Findings remained consistent across sensitivity analyses. Although these trends may reflect stronger oversight, advances in clinical trial design and regulatory coordination may also contribute. Faster regulatory timelines must be accompanied by timely generation of post-approval clinical evidence to maintain the integrity of the accelerated approval pathway.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100597"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231568","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}