Journal of Cancer Policy最新文献

{"title":"Cancer-related out-of-pocket costs in advanced cancer patients in Spain: Functional dependence and socioeconomic inequalities","authors":"Alberto García-Martín ,&nbsp;Celia Sánchez-Gómez ,&nbsp;Susana Sáez-Gutiérrez ,&nbsp;Eduardo J. Fernández-Rodríguez","doi":"10.1016/j.jcpo.2026.100711","DOIUrl":"10.1016/j.jcpo.2026.100711","url":null,"abstract":"<div><h3>Background</h3><div>Advanced-stage cancer imposes a substantial economic burden on patients and families, even within universal public healthcare systems. Non-reimbursed direct costs—such as medications, parapharmacy products, and orthopaedic materials—pose a particularly severe impact on individuals with functional dependence and limited institutional support. This study focuses on the objective component of financial burden, operationalised as unreimbursed out-of-pocket (OOP) costs from a patient/household perspective.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted at a public hospital in Spain between January 2022 and January 2024, including 201 patients with advanced-stage cancer. Socio-demographic, clinical, and economic data were collected through structured interviews, including annual out-of-pocket expenses for the previous 12 months (nominal euros, 2022–2024, without inflation adjustment), alongside functional assessments (Barthel Index, Lawton–Brody Scale, ECOG Performance Status, EQ-5D). Non-parametric tests (Mann–Whitney U and Kruskal–Wallis; α = 0.05) examined associations, and exploratory multivariate regression models were applied to adjust for functional and socioeconomic factors.</div></div><div><h3>Results</h3><div>In the previous year, 67.7 % of participants reported pharmacy or parapharmacy expenses, and 10 % spent more than €1200. Orthopaedic costs were incurred by 54.2 %, despite theoretical public coverage; 23.9 % spent more than €600. Functional impairment was frequent, with 38.3 % of patients presenting ECOG ≥ 3. Only 25.4 % received any financial support, while the majority reported none. Pharmacy-related expenses were significantly higher among patients with greater functional dependence and income reductions (p &lt; 0.05). Additional associations were found with marital status and pre-diagnosis income.</div></div><div><h3>Conclusion</h3><div>Unreimbursed out-of-pocket costs represent a major source of objective financial burden in advanced cancer, disproportionately affecting patients with functional dependence and reduced household income. Current co-payment exemptions insufficiently capture vulnerable profiles.</div></div><div><h3>Policy summary</h3><div>These findings support national (Spain’s Cancer Strategy 2021–2025) and European (Cancer Inequalities Registry) frameworks aimed at reducing social and economic inequalities in cancer care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100711"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137989","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":"Evaluating the breadth of cancer diagnoses identified by the C the signs clinical decision support platform in primary care","authors":"Miles Payling ,&nbsp;Seema Dadhania ,&nbsp;Matt Lee ,&nbsp;Bea Bakshi","doi":"10.1016/j.jcpo.2025.100690","DOIUrl":"10.1016/j.jcpo.2025.100690","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100690"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394099","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 scalable, governed, and transparent AI ecosystem for oncology: the s-race platform for high-quality Real-World data research","authors":"Alberto Traverso ,&nbsp;Marco Denti ,&nbsp;Antonio Esposito ,&nbsp;Carlo Tacchetti","doi":"10.1016/j.jcpo.2025.100684","DOIUrl":"10.1016/j.jcpo.2025.100684","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100684"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394737","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":"DISPARITY BETWEEN AWARENESS AND UPTAKE OF CERVICAL CANCER PREVENTION SERVICES AMONG ZAMBIAN WOMEN","authors":"Emmanuel Mulube MD ,&nbsp;Krista Pfaendler MD, MPH","doi":"10.1016/j.jcpo.2025.100680","DOIUrl":"10.1016/j.jcpo.2025.100680","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100680"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394742","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":"Cross sectional analysis of long-term overall survival among patients taking immune checkpoint inhibitor drugs","authors":"Alyson Haslam ,&nbsp;Timothée Olivier ,&nbsp;Vinay Prasad","doi":"10.1016/j.jcpo.2025.100669","DOIUrl":"10.1016/j.jcpo.2025.100669","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have transformed the landscape of tumor therapy. Yet, little is known about the collective long-term survival from these therapies. We sought to characterize long-term survival.</div></div><div><h3>Methods</h3><div>In a cross-sectional analysis of US FDA oncology ICI drug approvals (2011–2023), we retrieved data from supporting registration trials. We examined the percentage of study participants surviving at 12-, 24-, 36-, and 60-months follow-up; the American Society of Clinical Oncology (ASCO) Value Framework Tail of the Curve calculation; and the correlation between the longest time with 10 % of patients still at-risk and the difference in the percentage of patients in each treatment group alive.</div></div><div><h3>Results</h3><div>Out of 88 included approvals, 20 (22.7 %) qualified for ASCO’s tail of the curve bonus. Twenty-seven studies (30.7 %) did not report OS at 12 months; 44 (50.0 %) did not report OS at 24 months; 60 (68.2 %) did not report OS at 36 months; and 78 (88.6 %) did not report OS at 60 months. We found no correlation between the last time that at least 10 % of patients were still at-risk and the difference in the percentage of patients in each group still alive at that time-point (R²=0.1; p = 0.30). Among 81 studies that reported an OS curve, the longest time with at least 10 % of participants at-risk was a median of 30 months. The median difference in survival was 8 %.</div></div><div><h3>Conclusions</h3><div>Few registration trials testing ICI oncology therapies report long-term overall survival data. The gathering and reporting of this information should be incentivized so that the value of these drugs for patients can be more readily assessed.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100669"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575073","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":"Economic burden of breast, cervical, and oral cancer in Bangladesh: a cost-of-illness study","authors":"Md. Ragaul Azim ,&nbsp;Quazi Nazmus Sakib ,&nbsp;Md. Mahfujur Rahman ,&nbsp;Md. Sirajul Islam ,&nbsp;Mushfika Binta Latif ,&nbsp;Md. Habibullah Talukder ,&nbsp;Syed Abdul Hamid","doi":"10.1016/j.jcpo.2025.100694","DOIUrl":"10.1016/j.jcpo.2025.100694","url":null,"abstract":"<div><h3>Background</h3><div>Breast, cervical, and oral cancers are leading causes of morbidity and mortality in Bangladesh, placing a heavy economic burden on households and the health system. Yet, this burden remains poorly understood, as no prior study has comprehensively examined their economic impact. Moreover, the profound psychological suffering experienced by patients are often overlooked in existing global evidence. Therefore, this study aims to estimate the comprehensive economic burden of breast, cervical, and oral cancers in Bangladesh from the household perspective.</div></div><div><h3>Methods</h3><div>Using a cross-sectional design, primary data were collected through structured interviews with 346 cancer patients. A cost-of-illness approach was employed. Direct medical and direct non-medical costs were estimated based on respondent-reported expenditures. Indirect costs, i.e.income loss, were calculated using the human capital approach. Intangible costs, reflecting pain and discomfort, were quantified using the willingness-to-pay method.</div></div><div><h3>Results</h3><div>The average total cost per patient was US$12,117, with breast cancer accounting for the highest burden. Intangible costs comprised 47.7 % of the total, underscoring the substantial psychological impact of cancer on patients. The combined national economic burden exceeded US$1.17 billion. Catastrophic health expenditure was nearly universal (99.1 %), with average treatment costs exceeding the catastrophic threshold by 44-fold. Expenditures were significantly higher among wealthier households, patients with longer disease duration, and those seeking care from multiple facilities.</div></div><div><h3>Conclusion</h3><div>Breast, cervical, and oral cancers impose a major financial and psychological burden on households in Bangladesh. The near-universal catastrophic health expenditure and high intangible costs highlight the urgent need for accessible and affordable cancer care.</div></div><div><h3>Policy summary</h3><div>Policies should strengthen financial protection, decentralize diagnosis and treatment, introduce insurance with cancer-specific benefits, establish an effective referral system, integrate psychosocial support and strengthen early detection programs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100694"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800774","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":"Current opinions on lung cancer screening in the Nordic countries: A survey-based study","authors":"Morten Borg ,&nbsp;Kirill Neumann ,&nbsp;Jannie Christina Frølund ,&nbsp;Ghida Khalife ,&nbsp;Zaigham Saghir ,&nbsp;Aija Knuuttila ,&nbsp;Haseem Ashraf ,&nbsp;Johan Isaksson ,&nbsp;Torben Riis Rasmussen","doi":"10.1016/j.jcpo.2026.100703","DOIUrl":"10.1016/j.jcpo.2026.100703","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer-related death worldwide, with early detection critical for curative treatment. Low-dose computed tomography (LDCT) can detect lung cancer at earlier stages, but its implementation in the Nordic countries remains limited. This study surveys invasive respiratory physicians in Sweden, Finland, Norway, and Denmark to explore their views on LDCT screening.</div></div><div><h3>Methods</h3><div>A web-based survey was conducted among invasive respiratory physicians in Denmark, Norway, Sweden, and Finland to assess opinions on lung cancer screening. Responses were analysed using descriptive statistics and the Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>A total of 125 respondents from 54 Nordic hospitals completed the survey. The majority reported no prior experience with LDCT screening. Most physicians were familiar with LDCT and recognized its potential to improve early detection, though opinions on national implementation were mixed. Key barriers identified included financial constraints, lack of trained personnel, and limited access to CT scanners. Significant differences were observed by country, hospital type, and years of clinical experience (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Nordic respiratory physicians acknowledge the benefits of LDCT screening for early lung cancer detection but highlight substantial implementation challenges, particularly related to resources and personnel. Addressing these barriers, standardizing protocols, and exploring supportive measures such as risk-scores and AI-assisted imaging will be essential for successful adoption of national screening programs across the Nordic region.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100703"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918859","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":"Lessons learned from the support of the International Atomic Energy Agency, International Agency for Research on Cancer and World Health Organization to develop National Cancer Control Plans in low- and middle-income countries","authors":"Lisa Montel ,&nbsp;John Russell ,&nbsp;Issimouha Dille Mahamadou ,&nbsp;Mary Nyangasi ,&nbsp;Sharon Katai Kapambwe ,&nbsp;Alfred Karagu Maina ,&nbsp;Valerian Mwenda ,&nbsp;Andre Carvalho ,&nbsp;Geraldine Arias de Göbl ,&nbsp;Marianna Nobile ,&nbsp;Yannick Romero ,&nbsp;Mauricio Maza ,&nbsp;Lisa M. Stevens","doi":"10.1016/j.jcpo.2025.100652","DOIUrl":"10.1016/j.jcpo.2025.100652","url":null,"abstract":"<div><h3>Background</h3><div>The International Atomic Energy Agency (IAEA), International Agency for Research on Cancer (IARC) and World Health Organization (WHO) assist countries in building and strengthening their cancer control capacity. This support includes guidance to Member States to set priorities for national cancer control through the development and implementation of National Cancer Control Plans (NCCPs). Our aim was to identify the lessons learned from the support United Nations (UN) agencies provide to develop NCCPs in low- and middle-income countries (LMICs) to support the development of guidance.</div></div><div><h3>Methods</h3><div>We developed a questionnaire based on a review of the NCCP literature and conducted semi-structured interviews with 11 Member States that received UN agency support between 2020 and 2023 and five IAEA Programme Officers who coordinated UN support. We coded the transcripts inductively and performed a thematic analysis of the data.</div></div><div><h3>Results</h3><div>Three main themes were identified, each with their own barriers and enablers to develop NCCPs: coordination of NCCP development; method; and governance. We discuss each of these challenges and offer recommendations for Member States and UN agencies to further improve the development process of national cancer control strategies. We selected Kenya as a case study to show an example of good practice.</div></div><div><h3>Conclusion</h3><div>This paper complements a sister study conducted by the International Cancer Control Partnership which assessed challenges of developing NCCPs for countries that received a different type of support. Both studies contribute to the growing body of NCCP literature following the 2025 global review of NCCPs.</div></div><div><h3>Policy summary</h3><div>The lessons learned from the IAEA-IARC-WHO support to develop NCCPs will inform policies, programmes and practices in cancer control planning and implementation in LMICs, as well as the development of a common methodology for UN agencies to provide NCCP support.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100652"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356399","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":"Accelerating cancer treatment optimisation: A multistakeholder roadmap from the Cancer Medicines Forum","authors":"Denis Lacombe ,&nbsp;Fábio Cardoso Borges ,&nbsp;Ana E. Amariutei ,&nbsp;Christopher M. Booth ,&nbsp;Guy Brusselle ,&nbsp;Raffaella Casolino ,&nbsp;Pierre Demolis ,&nbsp;Rosa Giuliani ,&nbsp;Daniel A. Goldstein ,&nbsp;Gwenaelle Gravis ,&nbsp;Martin Kaiser ,&nbsp;Iphigenie Korakis ,&nbsp;Momir Radulovic ,&nbsp;Richard Sullivan ,&nbsp;Bertrand Tombal ,&nbsp;Beate Wieseler ,&nbsp;Michael Zaiac ,&nbsp;Caroline Voltz-Girolt ,&nbsp;Francesco Pignatti","doi":"10.1016/j.jcpo.2025.100700","DOIUrl":"10.1016/j.jcpo.2025.100700","url":null,"abstract":"<div><div>Medicines are often tested in highly controlled environments during clinical trials aimed at rapid development and thorough assessment of their benefits and risks, with key efficacy and safety aspects evaluated for regulatory approval. However, important questions regarding the optimisation of medicines’ use in clinical practice may remain unanswered at the time of marketing authorisation, notably those related to the optimal dose, duration, schedule, sequence, and combination of treatments. This knowledge gap is particularly critical in oncology, where patient quality of life must be prioritised, and there is the pressing need to understand the most efficient use of costly innovative therapies in the context of rising cancer incidence and prevalence. Addressing these challenges requires multi-stakeholder collaboration.</div><div>Organisations within the Cancer Medicines Forum (CMF), co-chaired by the European Organisation for Research and Treatment of Cancer and the European Medicines Agency, have advocated for policy actions promoting treatment optimisation research within the European Union. To advance this objective, the CMF convened a multidisciplinary stakeholder workshop, offering a platform for collaborative dialogue by bringing together experts from governmental bodies, regulatory agencies, health technology assessment bodies, patient organisations, academia, learned societies, industry, public health organisations, clinicians, and investigators. This workshop aimed to examine existing barriers and explore strategies to integrate treatment optimisation into the current cancer clinical research framework, ultimately providing key recommendations, summarised in this review, to systematically embed treatment optimisation in oncology research.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100700"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925520","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":"Innovative oncology trial designs: Time to act – A review with recommendations of the Cancer Drug Development Forum","authors":"Rosa Giuliani ,&nbsp;Nafsika Kronidou-Horst ,&nbsp;Christina Yap ,&nbsp;Aáron Sosa Mejia ,&nbsp;Lada Leyens ,&nbsp;Theodor Framke ,&nbsp;Fergus Sweeney ,&nbsp;Laurence Collette ,&nbsp;Rachel Giles ,&nbsp;Jan Bogaerts ,&nbsp;Peter van de Ven ,&nbsp;Stefan N. Symeonides","doi":"10.1016/j.jcpo.2025.100696","DOIUrl":"10.1016/j.jcpo.2025.100696","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical oncology trial design constantly adapts and evolves to meet the needs of all stakeholders, from patients to regulators. This evolution has however also led to an increase in the complexity of clinical development, and investigators are expected to invest more time and money in planning and running their studies and overall clinical and regulatory pathway.</div></div><div><h3>Methods</h3><div>Here we review recent innovations in trial designs, study endpoints, and relevant regulatory guidelines, before making recommendations to enhance the clinical trial ecosystem in the EU.</div></div><div><h3>Results</h3><div>Innovative clinical study designs that go beyond traditional randomised, double-blinded, placebo-controlled trials often promise greater flexibility and efficiency in the conduct of oncology studies, but adoption has been slow. Furthermore, the increased complexity associated with innovative trials means that coordination between all relevant stakeholders is essential to every phase of clinical development. Despite recent advances, there is a risk that Europe is becoming seen as a less attractive location for clinical trials, and this article outlines initiatives and possible steps to improve patient access to medicines and processes across Europe.</div></div><div><h3>Policy summary</h3><div>Innovative trial designs promise more efficient, flexible, and inclusive clinical trials, but more needs to be done to encourage their adoption if the advantages outweigh the limitations. Partnership and coordination between all stakeholders, from patients to regulators, and at all phases, is more important than ever. Finally, effective action is needed to make Europe a more attractive destination for clinical research and to improve access to innovative medicines for patients.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100696"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805869","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}