Journal of Cancer Policy最新文献

{"title":"Achieving digital transformation in cancer care across Europe: Practical recommendations from the TRANSiTION project","authors":"Dimitrios Protogiros ,&nbsp;Constantina Cloconi ,&nbsp;Theologia Tsitsi ,&nbsp;Iolie Nicolaidou ,&nbsp;Efthyvoulos Kyriacou ,&nbsp;Norbert Couespel ,&nbsp;Deborah Moreno-Alonso ,&nbsp;Carme Carrión ,&nbsp;Ana Claveria ,&nbsp;Andreas Charalambous","doi":"10.1016/j.jcpo.2025.100584","DOIUrl":"10.1016/j.jcpo.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Digital transformation in cancer care requires a comprehensive integration of digital technologies, data analytics, and innovative processes to enhance the delivery of healthcare services. Achieving digital transition relies on the appropriate preparation of the oncology workforce through adequate education and training in digital solutions. The aim of the current paper was to develop a recommendations scheme for digital transition in oncology through healthcare professionals’ and health managers’ digital training.</div></div><div><h3>Methods</h3><div>A mixed methods approach including a rapid literature review on relevant articles, guideline papers and statements of European organisations that was incorporated in expert’s panel survey was performed. This paper is part of the EU funded project entitled “TRANSiTION” - Digital TRANSition and dIgiTal resiIlience in Oncology.</div></div><div><h3>Results</h3><div>Four levels of recommendations arisen from the current study and include actions in the following areas: (i.) policy, (ii.) education (iii.) clinical practice and (iv.) research. These recommendations are interrelated and collaboration between all relevant stakeholders is crucial on a national, transnational and European level.</div></div><div><h3>Conclusions</h3><div>The recommendations proposed in this paper could have an impact on the digital transformation in cancer care across Europe. Strong leadership on a policy level, coordination and cooperation among the relevant stakeholders is the stepping stone to a successful and swift digital transition in healthcare systems.</div></div><div><h3>Policy summary</h3><div>The recommendations aims to impact several key policies and policy improvements in Europe, including regulatory frameworks on digital health technologies; data sharing and interoperability; digital literacy among both patients and healthcare professionals and health managers and the use of digital tools for patient-centered care, to harness the full potential of digital transformation in cancer care, ultimately leading to better patient outcomes and more efficient healthcare systems.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100584"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816419","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":"Challenges and opportunities in ovarian cancer care: A qualitative study of clinician perspectives from 24 low- and middle-income countries","authors":"Anmol Bajwa ,&nbsp;Runcie C.W. Chidebe ,&nbsp;Tracey Adams ,&nbsp;Garth Funston ,&nbsp;Isabelle Soerjomataram ,&nbsp;Robin Cohen ,&nbsp;Rafe Sadnan Adel ,&nbsp;Ngoc Phan ,&nbsp;Dilyara Kaidarova ,&nbsp;Raikhan Bolatbekova ,&nbsp;Basel Refky ,&nbsp;Florencia Noll ,&nbsp;Mary Eiken ,&nbsp;Martin Origa ,&nbsp;Asima Mukhopadhyay ,&nbsp;Sara Nasser ,&nbsp;Iren Lau ,&nbsp;Thomas Konney ,&nbsp;Afrin Fatima Shaffi ,&nbsp;Precious Takondwa Makondi ,&nbsp;Frances Reid","doi":"10.1016/j.jcpo.2025.100582","DOIUrl":"10.1016/j.jcpo.2025.100582","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian cancer poses a significant and growing burden, particularly in low- and middle-income countries (LMICs) where incidence and mortality are projected to increase by over 50 % by 2050. However, there is a critical lack of qualitative data on the challenges and opportunities for improvement in treatment and care for women with ovarian cancer in these regions. The aim of this research is to investigate clinicians’ perspectives on the matter in 24 LMICs.</div></div><div><h3>Methods</h3><div>As part of the multi-country observational Every Woman Study™ (EWS), semi-structured interviews were conducted with clinicians between June 2022 and June 2023. The interview guide was developed by the EWS LMIC Oversight Committee, including patients, clinicians and data specialists. Relational content and inductive thematic analyses were employed and categories synthesized using the World Health Organization’s six building blocks of the Health Systems Framework.</div></div><div><h3>Results</h3><div>24 clinicians (54 % female; 79 % gynaecologic oncologists, 8 % gynaecologists, 8 % clinical oncologists not specializing in gynaecological cancers, and 4 % clinical oncologists specializing in gynaecological cancers; 42 % from Africa, 29 % from Asia, 29 % from Latin America) participated. Six dominant themes were identified: “Poor Ovarian Cancer Data'', “Inequity in Access to Treatment”, “In-Country Inequities in Access to Care”, “Role of Cultural Norms on Women's Health”, “Increased Engagement of Men in Ovarian Cancer Control”, and “Advocacy and Education for Empowering Women”. Content analysis revealed system-level challenges such as delayed drug payments, lack of population-based cancer data, and limited imaging facilities. Patient-level challenges included disparities in access to specialists, limited medication affordability, poor symptom recognition, and reliance on alternative treatments.</div></div><div><h3>Conclusions and policy summary</h3><div>This study reveals the complexity of ovarian cancer treatment and care in LMICs and the need to mitigate disparities in these regions, underscoring the need for patient-centred, context specific and intersectoral strategies to be considered in cancer planning to improve ovarian cancer care quality and equity in LMICs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100582"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834123","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 role of the acute oncology service in a comprehensive cancer management pathway","authors":"H. Williams,&nbsp;E. Marshall,&nbsp;A. Lillis,&nbsp;C. O’Doherty,&nbsp;R. Christmas,&nbsp;O. Minton","doi":"10.1016/j.jcpo.2025.100583","DOIUrl":"10.1016/j.jcpo.2025.100583","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100583"},"PeriodicalIF":2.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800054","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":"Research on the issue of financial toxicity in cancer: A systematic review of the literature","authors":"Loukas Sideris,&nbsp;Eleftheria Karampli,&nbsp;Kostas Athanasakis","doi":"10.1016/j.jcpo.2025.100581","DOIUrl":"10.1016/j.jcpo.2025.100581","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;This review aims to investigate Financial Toxicity (FT) among cancer patients across several different healthcare systems. It identifies factors that contribute to FT and proposes policies to mitigate its effects on cancer patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Articles published between January 1st 2017 and March 31st 2022, describing Financial Toxicity experienced by cancer patients, were identified using PubMed, Scopus, Springer, and Science Direct databases. Papers written in English language, quantitative papers describing studies conducted in countries with public and mixed healthcare systems were considered eligible.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Based on 7917 records screened, 61 publications met our inclusion criteria. According to our findings, the referred prevalence of financial toxicity among cancer patients was up to 54 % in the United States, 44.7 % in high-income nations with public healthcare systems, and 80.4 % in low-income nations. Worse financial toxicity is linked to age under 65 years, low income, insurance status, high monthly out-of-pocket expenses, and cancer-related factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Financial toxicity is a widespread issue among cancer patients, and it is influenced by both socioeconomic and cancer-related factors, even in different countries and healthcare systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Patients who suffer from cancer often face very serious financial problems. The source of these problems is the increased cost of both the treatments and the drugs that they have to take for long periods and often for their entire lives, so there is a risk that patients do not have the necessary income to cover these costs, leading to patients’ developing coping mechanisms such as not fully adhering doctors' instructions for treatment or even forgoing treatment, hence, putting their lives in immediate danger. This phenomenon is called financial toxicity.&lt;/div&gt;&lt;div&gt;The cost of treatments as well as the financial burden borne by patients is not the same for everyone and depends both on the coverage of these expenses provided by each country's health system and on the personal characteristics of each patient such as age, amount of income, the existence or not of insurance coverage, daily out-of-pocket expenses as well as characteristics of the cancer such as the stage, type and metastatic disease.&lt;/div&gt;&lt;div&gt;To improve the situation, it will be necessary to implement coordinated efforts between patients, providers, health systems, payers, and policy makers at multiple levels.&lt;/div&gt;&lt;div&gt;For example, to tackle financial toxicity among cancer patients, tools could be implemented to identify those most vulnerable, considering factors like income, insurance coverage, and treatment costs. Hospitals could also establish financial counseling structures to help patients make the best treatment decisions based on to their financial status.&lt;/div","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100581"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774428","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":"“But if you don't know what my needs are, you can't help me\": Health seeking experiences of older Black and Latinx cancer survivors","authors":"Candidus Nwakasi ,&nbsp;Jyotsana Parajuli ,&nbsp;Sarah Ahmed ,&nbsp;Obinna Odo ,&nbsp;Kingsley Udeh ,&nbsp;Chizobam Nweke","doi":"10.1016/j.jcpo.2025.100579","DOIUrl":"10.1016/j.jcpo.2025.100579","url":null,"abstract":"<div><h3>Background</h3><div>More research on minoritized individuals’ health-seeking experiences is necessary to address disparities in cancer survivorship. To fill this critical gap in the literature, this study explored the health-seeking experiences of older Black and Latinx populations in the United States (U.S.), guided by the intersectionality framework.</div></div><div><h3>Method</h3><div>Using a qualitative descriptive design, participants were recruited from the New England region of the U.S. Inclusion criteria were: a) 50 years or older, b) Black or Latinx person or both, c) a history of cancer diagnosis, and d) could speak English or Spanish. A semi-structured interview guide was used for data collection, and data were analyzed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>A total of 17 (4 men and 13 women) cancer survivors with a mean age of 63.9 years participated in this study. Three main themes relating to health-seeking emerged from the study: 1) views about cancer as stigmatizing or not (“Because you can see how people are staying away from you”); 2) the impact of being a Black or Latinx cancer survivor (“America is a complex one that sometimes you could be neglected”); and the impact of being an immigrant (“If I had no help, why didn't I go back to my country”).</div></div><div><h3>Conclusion</h3><div>Minoritized older cancer survivors may experience what we term the <em>triple jeopardy on health seeking</em> due to the disabling effect of cancer, race/ethnicity, and immigration status/situation.</div></div><div><h3>Policy summary</h3><div>To strengthen health-seeking and eliminate cancer health disparities, it is important to design or enhance policies that address structural inequities, including racism and xenophobia, and support community-oriented programs to reduce cancer-related stigma.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100579"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734969","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":"Corrigendum to \"Sociodemographic, political, and policy contexts of cancer care: A comparative analysis of countries with the highest survival rates\" [J. Cancer Policy 43 (2025) 100559].","authors":"Alejandra Fuentes-García, Carla Flores-Figueroa, Alondra Castillo-Delgado","doi":"10.1016/j.jcpo.2025.100577","DOIUrl":"10.1016/j.jcpo.2025.100577","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100577"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744298","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":"Mismatch between evidence and related clinical recommendations about the treatment of advanced esophageal cancer patients with anticancer drugs: A critical historical review","authors":"Xavier Bonfill Cosp ,&nbsp;Olga Savall-Esteve ,&nbsp;Javier Bracchiglione ,&nbsp;Carolina Requeijo ,&nbsp;Marilina Santero ,&nbsp;Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC-Study) Research Group","doi":"10.1016/j.jcpo.2025.100580","DOIUrl":"10.1016/j.jcpo.2025.100580","url":null,"abstract":"<div><h3>Purpose</h3><div>to analyze the most robust research and recommendations that have informed the potential superiority of treatments with anticancer drugs over any type of supportive care for advanced esophageal cancer (EC).</div></div><div><h3>Methods</h3><div>We conducted a critical historical review. First, we identified randomized clinical trials (RCTs) from a previous scoping review conducted by our research group, ASTAC, updating the search strategy. Second, we searched for the most important and recognized international clinical practice guidelines (CPGs) in advanced EC. Finally, we performed a systematic document analysis to compare whether the recommendations proposed in the CPGs were supported by the previously identified relevant evidence.</div></div><div><h3>Results</h3><div>We identified and assessed 15 RCTs and 11 CPGs from ESMO (eight), ASCO (two), and NICE (one) published over the last 40 years. There is a clear mismatch between these guidelines' recommendations and the available RCTs regarding the efficacy of anticancer drugs compared to best supportive care (BSC).</div></div><div><h3>Conclusion</h3><div>There is a lack of consistent evidence to support the treatment of advanced EC patients with anticancer drugs, and a notable mismatch exists between the available evidence and the recommendations made by relevant CPGs. As a result, these guidelines may be biased in favoring the use of anticancer drugs over supportive care and in consequence it is advisable to be very prudent when proposing systemic treatments to patients with advanced EC. Further rigorous and independent research is needed to better evaluate the true benefits of anticancer treatments in advanced EC and to update the CPGs accordingly.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100580"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732079","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":"Characteristics of professional society oncological drug evaluation in the Netherlands from 2016 to 2020: A retrospective analysis","authors":"B.M.F. Penninx ,&nbsp;M.J. Samson ,&nbsp;A.J. Duits ,&nbsp;J.B. Schnog","doi":"10.1016/j.jcpo.2025.100578","DOIUrl":"10.1016/j.jcpo.2025.100578","url":null,"abstract":"<div><h3>Background</h3><div>In the Netherlands oncological drug approvals by the European Medicines Agency (EMA) are evaluated for added clinical benefit by the cieBOM (commission ‘Beoordeling Oncologische Middelen’). A positive evaluation (further depicted as ‘approval’) by the cieBOM is of value in drug reimbursement decision making. In this study we explore characteristics of drug evaluations by the cieBOM.</div></div><div><h3>Methods</h3><div>We identified new drugs and drug indications for malignant solid tumours approved by the American Food and Drug Administration (FDA) and/or EMA from January 2016 to December 2020 and compared these to assessments by the cieBOM.</div></div><div><h3>Results</h3><div>A total of 136 new drug indications were identified of which 133 were evaluated by the FDA, 111 were evaluated by EMA and 87 were evaluated by cieBOM. The cieBOM initially approved 76 of 104 (73 %) EMA-approved indications, and 76 of 124 (61 %) of all FDA-approved indications. cieBOM approvals were more often based on phase III trials. Neither the percentage of approvals with an OS benefit, nor the magnitude of benefit, nor the hazard ratio for death differed significantly between agencies. PFS and QoL gains for approvals were also similar between agencies.</div></div><div><h3>Discussion</h3><div>The cieBOM evaluated less new drug indications and subsequently approved less often as compared to the EMA and the FDA, with approvals more frequently based on phase III trials. The gain in clinical or surrogate endpoints did not differ between cieBOM and FDA or EMA approvals. Globally, stricter criteria for both selection of studies to be assessed by advisory commissions such as cieBOM and drug approval agencies are needed in order to limit the advent of new drugs and drug indications to only those of high value.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100578"},"PeriodicalIF":2.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704570","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":"Barriers to radiotherapy completion in breast cancer patients: A retrospective analysis from a tertiary hospital in Indonesia","authors":"Marhendra S. Utama ,&nbsp;Setiawan ,&nbsp;Hanna Goenawan ,&nbsp;Soehartati Ghondowiardjo ,&nbsp;Antony A. Adibrata","doi":"10.1016/j.jcpo.2025.100574","DOIUrl":"10.1016/j.jcpo.2025.100574","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality in Indonesia. Radiotherapy is a crucial treatment modality to improve local control, reduce recurrence, and enhance survival rates. However, access to radiotherapy remains limited, leading to prolonged waiting times and potential treatment incompletion. This study aims to identify key predictors influencing radiotherapy completion and analyze waiting times in a resource-limited setting</div></div><div><h3>Methods</h3><div>A retrospective study was conducted on breast cancer patients who underwent radiotherapy between January 2018 and December 2019 at Hasan Sadikin General Hospital, Indonesia. Data were obtained from the Hospital-Based Cancer Registry (HBCR). Statistical analyses were performed using chi-square and Mann-Whitney U tests to assess factors influencing radiotherapy completion and waiting time.</div></div><div><h3>Results</h3><div>279 Breast cancer patients were included. 77.8 % (n = 217) completed their prescribed radiotherapy. Significant predictors of completion include age, those older than 65 years old tend to do not complete their radiation treatment (p = 0.035). Those receiving treated using Linac radiotherapy had higher completion rates than those treated with Co-60. However, waiting time was not significantly associated with treatment completion (p = 0.427). The median radiotherapy waiting time was 8 weeks (0–40 weeks). Patients with metastatic disease (p &lt; 0.001) and those receiving palliative intent radiotherapy (p &lt; 0.001) experienced significantly shorter waiting times.</div></div><div><h3>Conclusion</h3><div>Radiotherapy completion rates among breast cancer patients in Indonesia remain suboptimal, with access disparities affecting treatment adherence. Addressing logistical and systemic barriers could improve outcomes and enhance cancer care delivery in resource-limited settings.</div></div><div><h3>Plain language summary</h3><div>Breast cancer is the most common cancer among women in Indonesia. Many patients require radiotherapy to prevent the disease from coming back and to improve survival. However, some patients do not complete their treatment due to long waiting times and other challenges. This study looks at how long patients wait for radiotherapy and what factors influence whether they complete treatment. We analyzed the medical records of 279 breast cancer patients who received radiotherapy at Hasan Sadikin General Hospital between 2018 and 2019. We examined their age, radiation therapy tools, waiting time, and whether they completed radiotherapy. We used statistical methods to find patterns and associations between these factors. Our findings suggest that certain groups of patients, especially older individuals and those undergoing curative treatment, may need additional support to complete their radiotherapy.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100574"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644187","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":"Availability, affordability and health insurance coverage of breast cancer services in Iran - An analysis based on the Universal Health Coverage-Service Planning Delivery and Implementation tool","authors":"Zahra Goudarzi ,&nbsp;Mojtaba Nouhi ,&nbsp;Majid Heydari ,&nbsp;Leon Bijlmakers","doi":"10.1016/j.jcpo.2025.100571","DOIUrl":"10.1016/j.jcpo.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>As part of efforts to achieve Universal Health Coverage for priority conditions in Iran, it is crucial to evaluate the breast cancer service package and identify aspects that may require adjustment. This study analyzes the current state of breast cancer service supply, service delivery platforms, health insurance coverage, and patient co-payment levels.</div></div><div><h3>Methods</h3><div>The Universal Health Coverage Compendium (UHCC) developed by WHO served to list and distinguish various types of breast cancer services. Information from health insurance agencies in Iran was obtained on actual service provision in the country. The Universal Health Coverage Service Planning Delivery and Implementation (UHC-SPDI) tool was used to assess the scope of breast cancer service delivery in Iran and human workforce levels, and to identify possible gaps in service coverage.</div></div><div><h3>Results</h3><div>All 73 actions listed as breast cancer services in the UHC-SPDI are provided in the Iranian healthcare system, with a strong reliance on out-patient centers and hospitals rather than primary health care facilities as service delivery platforms, reflecting suboptimal integration of service delivery. Eighty-seven percent of the services are recognized and accepted by health insurance agencies, with cost coverage levels ranging from 20 % for magnetic resonance imaging to 100 % for intravenous targeted therapy for metastasis. Genomic tests and four medicines (Pembrolizumab, Pertuzumab, Anastrozole, and Fluorouracil) are not covered by health insurance.</div></div><div><h3>Conclusion</h3><div>The UHC-SPDI has offered an instrumental framework for a comprehensive assessment of Iran’s national breast cancer service package composition by connecting it to the service delivery system and human resources competencies. There is room for improvement of the breast cancer service package in Iran, not only in terms of their health insurance coverage, but also in terms of their actual delivery.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100571"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644188","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}