{"title":"Beyond smoke: Status of flavored smokeless tobacco regulation in India","authors":"Amit Kumar Soni , Mohit Kumar","doi":"10.1016/j.jcpo.2024.100554","DOIUrl":"10.1016/j.jcpo.2024.100554","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100554"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923305","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":"Sexual health in women and sexual-gender-minority patients with cancer: A nationwide survey on healthcare professional awareness and attitude on behalf of MITO and AIRO-gynecology group","authors":"Amelia Barcellini , Chiara Cassani , Giulia Fontana , Ester Orlandi , Gabriella Macchia , Giorgia Mangili , Sandro Pignata , Laura Deborah Locati , Rossella E. Nappi","doi":"10.1016/j.jcpo.2024.100556","DOIUrl":"10.1016/j.jcpo.2024.100556","url":null,"abstract":"<div><h3>Background</h3><div>Compared to male patients, sexual health remains poorly studied in women and sexual gender minority (SGM) patients with cancers.</div></div><div><h3>Material and methods</h3><div>An online survey was developed by a multidisciplinary team to assess the awareness and attitude of Italian oncological providers facing sexual health during or after cancer treatment. On behalf of the respective scientific committees, the questionnaire was sent to Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies group (MITO) and to Italian Association of Radiation Oncology (AIRO) Group. Four dedicated sections analyzed participants' demographic data, clinical context, communication and assessment practices, possible barriers, and treatment approaches.</div></div><div><h3>Results</h3><div>A total of 184 clinicians responded to the survey for an overall response rate of 20.8 %. Patient’s gender identity and sexual orientation were not routinely assessed, and several barriers were recorded. There was a high attitude to talk about the iatrogenic potential of sexual dysfunction with patients, even if up to 39.7 % of the respondents declared average/extreme difficulty in facing this issue. Radiation and medical oncologists more frequently refer patients to dedicated specialists to manage iatrogenic sexual dysfunctions.</div></div><div><h3>Conclusions</h3><div>Sexual health is a key component of comprehensive care for female and SGM patients during their oncological journey. Despite the high attitude to talk about iatrogenic sexual dysfunctions in Italian providers, the present study highlighted the need for specific training and guidelines on sex-related health issues encountered by women and SGM patients.</div></div><div><h3>Policy summary</h3><div>Despite the recognized need for specialized care, there remain significant gap and barriers in knowledge regarding sexual health management in women and SGM patients. Our study highlights the urgent need to enhance healthcare provider training, equipping them with the necessary tools to recognize, discuss, and treat this type of toxicity, which has a significant impact on the social well-being and quality of life of long-term survivors.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100556"},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915747","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}
David Nelson, Mark Lawler, Ros Kane, Ben Pickwell-Smith, Samuel Cooke, Ava Harding-Bell, Kathie McPeake, Lynn Calman, Peter Selby
{"title":"A National Cancer Plan for England: Remember the needs of people in rural and coastal areas","authors":"David Nelson, Mark Lawler, Ros Kane, Ben Pickwell-Smith, Samuel Cooke, Ava Harding-Bell, Kathie McPeake, Lynn Calman, Peter Selby","doi":"10.1016/j.jcpo.2024.100553","DOIUrl":"10.1016/j.jcpo.2024.100553","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100553"},"PeriodicalIF":2.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883068","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":"Breaking barriers: The impact of telemedicine on improving soft tissue and bone tumor management in Armenia","authors":"Ruzanna Papyan , Shushan Hovsepyan , Julieta Hoveyan , Saten Hovhannisyan , Tatev Arakelyan , Gevorg Tamamyan , Lilit Sargsyan , Lusine Hakobyan , Levon Davtyan , Armine Lazaryan , Davit Dallakyan , Narek Manukyan , Armen Mkhitaryan , Nelli Grigoryan , Sybille Perkowski , Birgit Froehlich , Andreas Groll , Manfred Schiborr , Katja Glutig , Kai Kroeger , Heribert Jürgens","doi":"10.1016/j.jcpo.2024.100530","DOIUrl":"10.1016/j.jcpo.2024.100530","url":null,"abstract":"<div><h3>Purpose</h3><div>Musculoskeletal sarcomas are a rare group of malignant neoplasms, accounting for approximately 12 % of all malignant neoplasms among children. Childhood cancer outcomes vary between developed and developing countries due to financial and educational inequalities. Telemedicine programs have a huge impact on the quality of cancer care, helping to optimize resources for better cancer care in a resource-limited setting. In 2019, Armenia established multidisciplinary teams (MDT) with the guidance of international experts via telemedicine, significantly improving patients’ management diagnosed with sarcomas.</div></div><div><h3>Methods</h3><div>The musculoskeletal cancer working group, mentored by the University Hospital of Münster (UKM), conducted weekly virtual tumor boards to discuss cases, focusing on the review of pathological and radiological examinations. <strong>Results:</strong></div><div>From August 2019 to December 2023, the musculoskeletal cancer MDT discussed 151 musculoskeletal tumor cases via 74 MDT meetings. Imaging studies of all discussed cases were reviewed, while the review of histology images was performed for 93 % of cases. The pathology review led to changes in previously established diagnoses in eleven cases, which subsequently changed management. These led to altered local control strategies for 32 patients, with 5 requiring treatment abroad, and changes in chemotherapy regimens for 17 patients. Notably, there were no cases of treatment refusal post-implementation, a reduction from the previous 3 % refusal rate.</div></div><div><h3>Conclusion</h3><div>The successful telemedicine initiative, coupled with institutional support, improved the care of patients diagnosed with musculoskeletal tumors. The investment in telemedicine in developing countries not only enhances communications with international and local experts across various disciplines but also significantly improves the handling of patients diagnosed with sarcomas.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100530"},"PeriodicalIF":2.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822712","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":"Breast cancer in Bulgaria prior implementation of a national breast cancer screening program and certified breast centers","authors":"Mariela Vasileva-Slaveva , Desislava Kostova-Lefterova , Filip Simeonov , Angel Yordanov , Metodi Metodiev","doi":"10.1016/j.jcpo.2024.100531","DOIUrl":"10.1016/j.jcpo.2024.100531","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer (BC) survival has improved globally in the past years. Eastern Europe is a region with lack of epidemiological data and traditionally lower BC overall survival (OS). We aimed to investigate the epidemiology of BC in Bulgaria between 2012 and 2022 and the readiness of the state for implementing population based organized screening program.</div></div><div><h3>Methods and materials</h3><div>This is a retrospective study of 38 576 invasive BC cases registered in Bulgarian National Cancer Registry. We obtained data from publicly available sources - national institutes and regulatory agencies. We report descriptive statistics of distribution of cases and mammography units among the country and the compared survival of patient’s groups.</div></div><div><h3>Results</h3><div>75 % of patients are treated in the 9 biggest cities. They are younger, diagnosed earlier and have significantly better OS than the rest of the patients. Patients over 75 years represent 18.7 % of all. The 211 installed mammography systems can secure the implementation of organized BC screening.</div></div><div><h3>Discussion</h3><div>The survival gap between cities can be due to the limited access to care of older patients living in smaller cities. The model of collaboration between private and state centers can be highly effective in implementing of organized screening since in Bulgaria both can be reimbursed by the National Insurance Fund.</div></div><div><h3>Conclusion</h3><div>Further centralization of care probably would not have such an impact on treatment outcomes as improvement and monitoring the quality of the provided treatment. Organized BC screening in Bulgaria is needed and technically possible step towards improving survival.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100531"},"PeriodicalIF":2.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Maeng , Rebecca L. Hoffman , Virginia Sun , Robert P. Sticca , Robert S. Krouse
{"title":"Post-surgical acute care utilization and cost of care among cancer survivors with an ostomy: Findings from three large hospital systems in the United States","authors":"Daniel Maeng , Rebecca L. Hoffman , Virginia Sun , Robert P. Sticca , Robert S. Krouse","doi":"10.1016/j.jcpo.2024.100534","DOIUrl":"10.1016/j.jcpo.2024.100534","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe patterns of 6-month total cost of care and acute care utilization among cancer survivors who received ostomy surgeries in 3 large hospital systems in the United States between 2018 and 2022 and to identify reasons for acute care utilization.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using electronic medical records and the corresponding hospital revenue data obtained from 3 geographically diverse hospital systems in the United States was performed. 6-month all-cause post-surgical encounters subsequent to respective ostomy surgery dates were included. Clinical reasons for acute care utilization were captured and examined via available diagnosis codes.</div></div><div><h3>Results</h3><div>Mean six-month total cost of care per patient varied greatly by hospital and by payer type, ranging between $18,000 and $80,000. Inpatient care was the largest driver of these cost, accounting for 70 % of the total cost of care. In the sample, 56 % of the patients experienced one or more post-surgical inpatient admissions over a six-month period. Moreover, 26 % of the acute care events were associated with primary or secondary diagnosis codes potentially attributable to post-surgical ostomy-related complications, accounting for approximately 18 % of the total cost. Patients who received urostomy and/or had metastatic cancer had higher rates of acute care utilization, although statistical significances were not achieved.</div></div><div><h3>Conclusion</h3><div>The results are indicative of significant financial burdens as well as morbidities associated with post-surgical ostomy care that are common across hospital systems. Some of these cost burdens are potentially avoidable with improved ostomy follow-up care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100534"},"PeriodicalIF":2.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808116","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":"Trend of sales revenue by year for top selling cancer drugs in the US and the effect of loss of market exclusivity","authors":"Myung Sun Kim , Alyson Haslam , Vinay Prasad","doi":"10.1016/j.jcpo.2024.100533","DOIUrl":"10.1016/j.jcpo.2024.100533","url":null,"abstract":"<div><div>Biosimilars and generics have led to reduced cancer drug prices. The effect of biosimilar or generic drug competition on drug manufacturer revenue has not been previously described. In this study, the majority of top selling cancer drugs had a greater than 50 % decline in sales revenue within 2 years of generic or biosimilar market entry, reflecting both the decline in market share and reduction in unit drug price. This results in important drug manufacturer incentives, which may shape clinical trial agendas. The market structure incentives are unique for pharmaceutical companies due to the relatively short and limited duration of profitability. Policy changes such as patent reform leading to shorter duration of exclusivity may lead to greater incentive to expand low value indications in oncology.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100533"},"PeriodicalIF":2.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814190","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":"Rethinking public health in wartime: Smoking and long-term health outcomes amidst the war in Ukraine","authors":"Paweł Koczkodaj, Irmina Maria Michalek","doi":"10.1016/j.jcpo.2024.100532","DOIUrl":"10.1016/j.jcpo.2024.100532","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100532"},"PeriodicalIF":2.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796196","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 impact of conflict on cancer care in Libya","authors":"Abeir El-Mogassabi , Ibtisam Gheith Kaziri","doi":"10.1016/j.jcpo.2024.100528","DOIUrl":"10.1016/j.jcpo.2024.100528","url":null,"abstract":"<div><h3>Background</h3><div>The ongoing Libyan Civil Conflict, initiated in 2011, has had a devastating impact on the country's healthcare system, particularly cancer care. This review delves into the challenges faced by cancer patients and healthcare providers in Libya.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted to identify relevant studies, reports, and news articles relating to cancer care in Libya. The review focused on the impact of the conflict on cancer prevention, diagnosis, treatment, and palliative care.</div></div><div><h3>Results</h3><div>The conflict has significantly disrupted cancer care in Libya. Key challenges include limited access to care due to infrastructure damage and security concerns. Shortages of essential medications and medical equipment have hindered cancer treatment. Inadequate healthcare infrastructure, resulting from damage and destruction, limits the availability of diagnostic and treatment services. The shortage of skilled healthcare professionals exacerbates the situation. Additionally, the absence of reliable data on cancer incidence and mortality hinders effective planning and resource allocation.</div></div><div><h3>Policy summary</h3><div>To improve cancer care in Libya, urgent action is needed to address the challenges posed by the conflict. This includes increasing investment in healthcare infrastructure, providing adequate funding for cancer control programmes, and strengthening the capacity of healthcare workers. Additionally, international cooperation and support are essential to help Libya rebuild its healthcare system and provide quality cancer care to its citizens.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100528"},"PeriodicalIF":2.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796210","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":"Financial conflicts among physician speakers at the April 12, 2024 Oncology Drug Advisory Meeting: Who decided that MRD can be a novel regulatory endpoint in myeloma?","authors":"Noah J. Carr , Alyson Haslam , Vinay Prasad","doi":"10.1016/j.jcpo.2024.100529","DOIUrl":"10.1016/j.jcpo.2024.100529","url":null,"abstract":"<div><h3>Background</h3><div>In April 2024, the Oncology Drug Advisory Committee (ODAC) voted to approve minimal residual disease (MRD) as a new regulatory endpoint for multiple myeloma (MM) despite its poor trial-level surrogacy. This is expected to result in faster MM drug approvals, a potential boon for the pharmaceutical companies that make them. This study investigates the prevalence of financial conflicts of interest (FCOIs) with these companies among United States (US)-based physician speakers at the meeting.</div></div><div><h3>Methods</h3><div>Public data regarding the past 3 years of pharmaceutical company payments to US-based physician speakers at the ODAC meeting discussing MRD (available at <span><span>https://openpaymentsdata.cms.gov/</span><svg><path></path></svg></span>) were collected. For each general payment (GP), we recorded the amount, company payor, reason for payment, and associated products. Descriptive analyses were performed on payments from companies who manufacture MM therapeutics (MM payments).</div></div><div><h3>Results</h3><div>12 of the 20 physician speakers (60 %) eligible to have FCOIs recorded on the OpenPayments database received MM payments from 2021 to 2023, totaling more than $792,200. A majority of both voting and non-voting members had MM payments (median $11,800 and $764), most of which were consulting fees. Speakers earned more than 3.7 times as much from GPs associated with MM-related products compared to those associated with non-MM-related products.</div></div><div><h3>Conclusion</h3><div>Most US-based physician speakers at the April 2024 ODAC meeting had FCOIs from MM companies, including those with voting power.</div></div><div><h3>Policy summary</h3><div>Our findings highlight the need for greater policing of FCOIs among US-based physicians involved in cancer drug regulatory policy.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100529"},"PeriodicalIF":2.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796194","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}