Journal of Cancer Policy最新文献

{"title":"Ensuring equitable and affordable access to clean water for people living with cancer in a rural and coastal setting","authors":"Kathie McPeake ,&nbsp;Chloe North ,&nbsp;Emma Townend ,&nbsp;Kelly Dixon ,&nbsp;Louise Jeanes ,&nbsp;Samuel Cooke ,&nbsp;Ros Kane ,&nbsp;Peter Selby ,&nbsp;Mark Lawler ,&nbsp;David Nelson","doi":"10.1016/j.jcpo.2025.100572","DOIUrl":"10.1016/j.jcpo.2025.100572","url":null,"abstract":"<div><h3>Background</h3><div>The UN General Assembly (UNGA) stated that the right-to-water entitles everyone to accessible and affordable water. People living with cancer (PLWC) need water for numerous reasons including hydration, personal hygiene and infection control. In 2023, reports emerged of PLWC in Lincolnshire (UK) disconnecting their water supply from cost fears. We report on innovative ways to ease financial burden and provide equitable and affordable access to clean water for PLWC in rural and coastal settings.</div></div><div><h3>Methods</h3><div>Quantitative data from secondary care and qualitative data from community-practitioners investigating PLWC’s difficulties in accessing a clean and safe water supply were synthesised. A review of existing financial support identified no services directly addressing water. The Lincolnshire Living with Cancer Team approached water provider, Anglian Water sharing concerns, identifying common values, and confirming shared aims. A formal partnership was established to address these inequalities.</div></div><div><h3>Results</h3><div>Initial data reviews showed completion of 25,858 Extra Care Assessments between Jan-Sept 2023 (12 % increase on previous year). This has enabled over 30,000 people with long-term conditions, including PLWC, to access clean and affordable water, a personalised support package for their water bill, including income maximisation, debt management, payment breaks, and bill reductions.</div></div><div><h3>Conclusion</h3><div>Impacts of cancer extend beyond physical health, with many PLWC reporting financial distress. Some PLWC have taken extreme measures to reduce their water consumption when they actually need increased water volumes. A partnership approach between health, voluntary and community sectors with a water provider can help address these inequalities.</div></div><div><h3>Policy summary</h3><div>The study addresses national policy (NHS Long Term Plan 2019) by demonstrating how personalisation can be achieved for PLWC in a rural and coastal county. Internationally, it aligns to The European Code of Cancer Practice and seeks to contribute to its implementation UNGA Resolution 64/292, the universal human right to water and sanitation.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100572"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636406","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}

{"title":"Evaluation of travel time to colorectal cancer care and survival: A cohort study using cancer registry data in Osaka Prefecture, Japan","authors":"Mari Kajiwara Saito ,&nbsp;Shoko Wakamiya ,&nbsp;Kayo Nakata ,&nbsp;Mizuki Shimadzu Kato ,&nbsp;Yoshihiro Kuwabara ,&nbsp;Toshitaka Morishima ,&nbsp;Isao Miyashiro","doi":"10.1016/j.jcpo.2025.100573","DOIUrl":"10.1016/j.jcpo.2025.100573","url":null,"abstract":"<div><h3>Background</h3><div>Cancer care in Japan faces a major challenge in maintaining equity in access and efficiency. Care is provided on the basis of catchment area, referred to as a secondary medical area (SMA); at least one designated cancer care hospital (DCCH) is placed in every SMA. We aimed to evaluate travel time and net survival by SMA among patients diagnosed with colorectal cancer (CRC) in Osaka Prefecture, Japan.</div></div><div><h3>Methods</h3><div>We used cancer registry data for this cohort study and included patients diagnosed with CRC during 2013–2018. We evaluated equality in the utilisation of care by travel time between patients’ addresses and medical institutions for diagnosis or treatment in Osaka Prefecture. Travel time was compared by SMA of residence. We analysed which factors were associated with travel time using quantile regression. Efficiency was evaluated as un-standardised, age-standardised and stage-stratified three-year net survival by SMA of hospital for patients who received surgical resection.</div></div><div><h3>Results</h3><div>Among the 53,301 patients, the estimated median travel time was 27 (interquartile range 14 to 61, 90th percentile 82) minutes. Travel time varied between SMAs of residence by 20 minutes and types of hospital (prefectural DCCH versus non-DCCH) by 15 minutes at most. Regarding net survival, all SMA of hospital were within the 99.8 % control limits. However, around 40 % of hospitals had annual surgical volume below ten.</div></div><div><h3>Conclusions</h3><div>Travel time varied by SMA by 20 minutes at most. Although net survival was equalised across catchment areas, the current situation suggests an over-regionalisation of surgical care. The entire prefecture may need to reallocate resources to achieve higher efficiency.</div></div><div><h3>Policy Summary</h3><div>Reconfiguring cancer care might be inevitable to cut the waste of resource inputs, but access equity should also be considered when centralising care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100573"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630363","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}

{"title":"Measuring the impact of COVID-19 on time to treatment for individuals diagnosed with cancer in Manitoba, Canada using an interrupted time series analysis","authors":"Pascal Lambert ,&nbsp;Katie Galloway ,&nbsp;Allison Feely ,&nbsp;Oliver Bucher ,&nbsp;Piotr Czaykowski ,&nbsp;Pamela Hebbard ,&nbsp;Julian O. Kim ,&nbsp;Marshall Pitz ,&nbsp;Harminder Singh ,&nbsp;Grace Musto ,&nbsp;Kathleen M. Decker","doi":"10.1016/j.jcpo.2025.100576","DOIUrl":"10.1016/j.jcpo.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Delays in treatment can lead to increases in cancer morbidity and mortality. There were many concerns that the COVID-19 pandemic led to delays in cancer treatment. Several studies have examined this issue but with serious limitations. We conducted a study that addressed many of these limitations and evaluated changes in first treatment, surgery, systemic therapy, and radiation therapy (RT) during the pandemic for individuals diagnosed with cancer in Manitoba, Canada.</div></div><div><h3>Methods</h3><div>A population-based, quasi-experimental cross-sectional study with an interrupted time series analysis was used to examine time to first treatment (expressed as treatment rates accounting for the competing risk of death) before (January 2015–September 2019) and after (April 2020–December 2022) the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>When compared to the counterfactual scenario without COVID-19, first treatments were not received significantly later during the COVID-19 period for any cancer site. Individuals diagnosed with breast, colon, endocrine, or head and neck cancer had their first treatment within 90 days of diagnosis significantly sooner when comparing the COVID-19 period to the counterfactual. When examining type of treatment within one year of diagnosis, individuals diagnosed with breast cancer had surgery significantly later from April to June 2020 and systemic therapy significantly sooner from April 2020 to September 2021. Individuals diagnosed with colon cancer had surgery significantly sooner from April 2020 to June 2021 and individuals diagnosed with rectal cancer had RT significantly later from January to June 2021.</div></div><div><h3>Conclusions</h3><div>Although significantly impacted by COVID-19, the cancer care system in Manitoba was able to prioritize individuals diagnosed with cancer and modify treatment modalities resulting in no significant delays in first treatment between April 2020 and December 2022.</div></div><div><h3>Policy summary</h3><div>It will be important to assess long-term survival and if unaltered, the ongoing use of strategies first used in the pandemic might be justified.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100576"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619152","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}

{"title":"‘It felt like finding hope only to lose it again’: A grounded theory study of rare cancer policies in Bulgaria","authors":"Kostadin Kostadinov ,&nbsp;Georgi Iskrov ,&nbsp;Nina Musurlieva ,&nbsp;Rumen Stefanov","doi":"10.1016/j.jcpo.2025.100570","DOIUrl":"10.1016/j.jcpo.2025.100570","url":null,"abstract":"<div><div>Rare cancers, defined by an annual incidence of fewer than 6 per 100,000 cases, pose significant challenges due to their complexity, lack of expertise, and limited treatment options. In Bulgaria, these challenges are compounded by limited resources, fragmented care, and outdated policies. This study investigates policy stakeholder perspectives to identify gaps and propose policy alternatives for rare cancer care in Bulgaria, with implications for the broader European Union (EU) context. A grounded theory qualitative research design was employed to explore stakeholder insights. Eight key stakeholders, including policymakers, healthcare providers, patient advocates, and pharmaceutical representatives, participated in semi-structured interviews. Data was analyzed through thematic coding to map policy gaps and develop viable alternatives. Stakeholders highlighted significant gaps in funding, access to innovative therapies, and care organization. Four policy approaches emerged: Liberal, advocating for inclusivity and decentralized care; Conservative, emphasizing cost control and centralization; Balanced, integrating elements of both; and Status Quo, retaining the current system. While centered on Bulgaria, these findings address universal challenges in rare cancer care, offering a framework adaptable to other EU countries. Adopting tailored policies can reduce disparities, improve patient outcomes, and align national strategies with EU objectives, particularly under Europe’s Beating Cancer Plan and the EU Cancer Mission.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100570"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610658","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}

{"title":"Integrating ePROMs: A key opportunity for England’s National Cancer Plan","authors":"Sally Wheelwright,&nbsp;Ollie Minton,&nbsp;Kate Absolom,&nbsp;Corinne Faivre-Finn,&nbsp;Lesley Fallowfield,&nbsp;Alexandra Gilbert,&nbsp;Duncan Gilbert,&nbsp;Alison Large,&nbsp;Thitikorn Nuamek,&nbsp;James Price,&nbsp;Tim Williams,&nbsp;Janelle Yorke,&nbsp;Valerie Shilling","doi":"10.1016/j.jcpo.2025.100575","DOIUrl":"10.1016/j.jcpo.2025.100575","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100575"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610659","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":"Adding adjuvant drugs from distinct breast cancer trials.","authors":"Timothée Olivier, Vinay Prasad","doi":"10.1016/j.jcpo.2025.100568","DOIUrl":"10.1016/j.jcpo.2025.100568","url":null,"abstract":"<p><p>Studies conducted in perioperative settings have recently expanded the treatment options for early-stage operable breast cancer. These studies have different inclusion criteria, however they are not entirely mutually exclusive. It results that multiple treatment options may be available to the same patient, making the choice of therapy a significant challenge. The concurrent or sequential administration of these therapies has been suggested by expert panels or international guidelines. Yet combining therapeutic strategies that have been independently tested can be problematic. It is possible that the same subset of patients benefits from each therapy individually, meaning that combining them might offer no additional benefit. Moreover, the toxicity of those combinations - short and long-term - has not been assessed in phase 3 trials. Whether these toxicities and dose reductions offset gains is unknown. Here, we offer clinical scenario where this could happen, like combining pembrolizumab plus olaparib in triple-negative breast cancer, or olaparib plus CDK4/6 inhibitors in hormone receptor-positive disease. Although each therapy has shown efficacy in individual trials, the net gain of their combined or sequential use in the peri-operative setting remains unproven in phase 3 trials. This dilemma extends well beyond breast cancer as a growing number of agents continue to be approved in neoadjuvant or adjuvant space. A cautious evidence-driven approach is needed to ensure these strategies truly benefit patients. This could have important policy implications, including regulatory enforcement for combination trials rather than extrapolating from monotherapy data.</p>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100568"},"PeriodicalIF":2.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598070","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":"Patient-centered perspectives: Examining quality-of-life integration in recent phase III lung cancer trials (2019–2023)","authors":"Shreyas Kalantri ,&nbsp;Chiranjeevi Sainatham ,&nbsp;Greeshma N. Gaddipati ,&nbsp;Jayanth Reddy Tallapalli ,&nbsp;Rishabh Singh ,&nbsp;Goetz H. Kloecker","doi":"10.1016/j.jcpo.2025.100566","DOIUrl":"10.1016/j.jcpo.2025.100566","url":null,"abstract":"<div><h3>Background</h3><div>In the dynamic landscape of lung cancer treatment, marked by precision medicine advancements, addressing the persistent global health challenge of lung cancer requires nuanced evaluations beyond traditional endpoints like Overall Survival (OS). Both the US FDA and ASCO advocate for consistent integration of Quality of Life (QoL) and Patient-Reported Outcomes (PRO). This study evaluates the extent to which recent Phase III lung cancer trials incorporate QoL, highlighting implications for global cancer policy and research priorities.</div></div><div><h3>Methods</h3><div>This systematic review analyzed PubMed for Phase III lung cancer clinical trials involving anticancer drugs conducted between 2019 and 2023. The study assessed if QoL was included as an endpoint. Subgroup analyses categorized trials by cancer subtype (e.g., non-small cell lung cancer [NSCLC], small cell lung cancer [SCLC]). Analyses were also stratified by publication year to explore potential temporal trends. Subanalyses included impact factor categories (≥10 and &lt;10) and differentiation between superiority and noninferiority trials.</div></div><div><h3>Results</h3><div>191 Phase III lung cancer clinical trials published between 2019 and 2023, meeting the criteria were included in this study. QoL was included in 31.93 % of trials across all subtypes, 33.72 % of NSCLC trials incorporated QoL vs 19.04 % of SCLC trials included QoL. Our analysis reveals a significant shortfall in incorporating quality of life (QoL) as an endpoint, highlighting a crucial gap in evaluating the comprehensive impact of interventions.</div></div><div><h3>Conclusions</h3><div>The limited integration of QoL assessments in lung cancer trials underscores a missed opportunity to inform patient-centered care and highlights disparities across cancer subtypes. To address these gaps, global cancer policy should prioritize standardized QoL measures in clinical trial design. This shift is essential for aligning research with patient needs, ensuring equitable evaluation of treatment impacts, and advancing value-based care in oncology.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100566"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577400","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":"Capturing breast cancer subtypes in cancer registries: Insights into real-world incidence and survival","authors":"Larissa Vaz-Gonçalves ,&nbsp;Louise Marquart-Wilson ,&nbsp;Melinda M. Protani ,&nbsp;Meghan T. Stephensen ,&nbsp;Julie Moore ,&nbsp;Michelle F. Morris ,&nbsp;Jodi M. Saunus ,&nbsp;Marina M. Reeves","doi":"10.1016/j.jcpo.2025.100567","DOIUrl":"10.1016/j.jcpo.2025.100567","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer treatment is guided by diagnostic subtyping, yet cancer registries do not routinely capture this information, and real-world studies reporting subtype-specific incidence and survival do not reflect contemporary clinical management.</div></div><div><h3>Methods</h3><div>We analysed breast cancer incidence and survival using Queensland cancer registry data (2017–2019), stratifying by hormone receptor (HR) and HER2 status.</div></div><div><h3>Results</h3><div>Subtype-specific, age-standardised incidence rates were: 125.6 HR+/HER2- cases/100,000 women (76.0 % of all diagnoses), followed by 17.7/100,000 for triple-negative (TNBC; 10.3 %), 15.0/100,000 for HR+/HER2 + (8.7 %), and 8.6/100,000 for HR-/HER2 + (5.0 %). Compared to HR+/HER2-, all other subtypes had poorer breast cancer-specific survival (BCSS) and overall survival (OS; except HR +/HER2 + for OS) at 2-years, with OS associations attenuated but still significant for TNBC at 4-years. Stratifying by stage at diagnosis, TNBC had consistently poorer 2-year BCSS in those with stage I-III TNBC (HR_adj&gt;7), and marginally poorer in those with stage IV.</div></div><div><h3>Conclusions</h3><div>HR+/HER2- breast cancer is the most common subtype and has the best short-term prognosis. TNBC has markedly poorer short-term survival, even when diagnosed at an early stage. This study provides real-world data for benchmarking breast cancer incidence and survival, and highlights the importance of capturing receptor status and stage for cancer surveillance.</div></div><div><h3>Policy summary</h3><div>Routinely capturing breast cancer subtypes and stages in cancer registries needs to be prioritised to assess the real-world efficacy of evolving targeted therapies and to inform tailored surveillance for high-risk subtypes.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100567"},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568497","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}

{"title":"Delivering quality cancer care in rural and coastal settings: Experiences of a large-scale integrated cancer transformation programme","authors":"David Nelson ,&nbsp;Kathie McPeake ,&nbsp;Samuel Cooke ,&nbsp;Ros Kane ,&nbsp;Peter Selby","doi":"10.1016/j.jcpo.2024.100544","DOIUrl":"10.1016/j.jcpo.2024.100544","url":null,"abstract":"<div><div><strong>Short introduction text:</strong> This abstract reports on the success of the system-wide, integrated Macmillan Living with Cancer Programme in the predominantly rural and coastal setting of Lincolnshire, England.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100544"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562241","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":"Enhancing early detection of ovarian cancer: A retrospective analysis using C the signs clinical decision support system","authors":"S. Dadhania ,&nbsp;R. Edgerley ,&nbsp;D. Milliken ,&nbsp;B. Bakshi ,&nbsp;M. Payling","doi":"10.1016/j.jcpo.2024.100552","DOIUrl":"10.1016/j.jcpo.2024.100552","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"43 ","pages":"Article 100552"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562144","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}