Barriers in access to cancer treatment in Europe: a systematic review of the European Literature

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Jachmann ◽  
K Klingberg ◽  
M C Zapata-Garcia ◽  
D S Srivastava ◽  
A Exadaktylos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Therapy ◽  
Health System ◽  
Cancer Treatment ◽  
Grey Literature ◽  
European Countries ◽  
Cancer Site ◽  
Cancer Drugs ◽  
System Factors

Abstract Background Within NCD`s, Cancer accounts for the 2nd most frequent cause after Cardiovascular diseases and in some European countries it´s the leading cause of premature deaths. One of the challenges within cancer therapy can be found in inequity in access to cancer treatment, because this causes worse health outcomes, which are attributable to the accessibility of health care and thus avoidable. The objective of the systematic review was to identify barriers in access to cancer treatment in Europe (inter-country) and within 6 European countries (intra-country): Spain, Germany, Switzerland, Finland, Bulgaria, UK. Methods To obtain data scientific (PubMed, CINAHL, Embase) and grey literature were searched using keywords relating to inequity in access to cancer therapy in Europe. Collected Abstracts of published articles in English between 01/2013 and 05/2018 were reviewed independently. Identified barriers in access to cancer therapy were grouped into 2 categories: patient and health system/provider factors, followed by thematic analysis for each category. Results Out of 786 unique articles, 14 were included in the systematic review. The most frequent cited barriers within Europe were patient socioeconomic status (n = 7, 50%), age (n = 4, 28.6%) and reimbursement and availability of cancer medicine (n = 4, 28.6%). Conclusions This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized. The amount of available studies with main focus on barriers in access to cancer therapy in Europe varies by equity stratifier, cancer site and type of treatment and seems to be very limited, showing a need for future investigations upon this topic with possibly uniform scales. Key messages This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized.

scholarly journals Zinc as a complementary treatment for cancer patients: a systematic review

2021 ◽  
Author(s):  
C. Hoppe ◽  
S. Kutschan ◽  
J. Dörfler ◽  
J. Büntzel ◽  
J. Büntzel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Survival Data ◽  
Positive Impact ◽  
Oral Intake ◽  
Quality Reporting ◽  
Evidenced Based

AbstractZinc is a trace element that plays an important role in the immune system and cell growth. The role of zinc in cancer treatment has been discussed for some time, however without reaching an evidenced-based consensus. Therefore, we aim to critically examine and review existing evidence on the role of zinc during cancer treatment. In January 2019, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychINFO, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of zinc therapy on cancer patients. Out of initial 5244 search results, 19 publications concerning 23 studies with 1230 patients were included in this systematic review. The patients treated with zinc were mainly diagnosed with head and neck cancer and underwent chemo-, radio- or concurrent radio-chemotherapy. Interventions included the intake of different amounts of zinc supplements and oral zinc rinses. Outcomes (primary endpoints) investigated were mucositis, xerostomia, dysgeusia, pain, weight, dermatitis and oral intake of nutrients. Secondary endpoints were survival data, quality of life assessments and aspects of fatigue, immune responses and toxicities of zinc. The studies were of moderate quality reporting heterogeneous results. Studies have shown a positive impact on the mucositis after radiotherapy. No protection was seen against mucositis after chemotherapy. There was a trend to reduced loss of taste, less dry mouth and oral pain after zinc substitution. No impact was seen on weight, QoL measurements, fatigue, and survival. The risk of side effects from zinc appears to be relatively small. Zinc could be useful in the prevention of oral toxicities during irradiation. It does not help in chemotherapy-induced side effects.

scholarly journals Identifying important health system factors that influence primary care practitioners’ referrals for cancer suspicion: a European cross-sectional survey

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022904 ◽  
Author(s):  
Michael Harris ◽  
Peter Vedsted ◽  
Magdalena Esteva ◽  
Peter Murchie ◽  
Isabelle Aubin-Auger ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Factor Analysis ◽  
Health System ◽  
Health Systems ◽  
European Countries ◽  
Cancer Symptoms ◽  
Referral Decision ◽  
System Factors ◽  
Primary Care Practitioners

ObjectivesCancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners’ (PCPs’) referral decisions is lacking.This study analyses health system factors potentially influencing PCPs’ referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.DesignBased on a content-validity consensus, a list of 45 items relating to a PCP’s decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs’ referral decision-making.SettingA primary care study; 25 participating centres in 20 European countries.Participants1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measuresThe factors derived from items related to PCPs’ referral decision-making. Mean factor scores were produced for each country, allowing comparisons.ResultsFactor analysis identified five underlying factors: PCPs’ ability to refer; degree of direct patient access to secondary care; PCPs’ perceptions of being under pressure; expectations of PCPs’ role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.ConclusionsFive healthcare system factors influencing PCPs’ referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

Catching the wave: Industry 4.0 in BRICS

2020 ◽  
Vol 31 (6) ◽  
pp. 1169-1184 ◽  
Author(s):  
Amaya Erro-Garcés ◽  
Irene Aranaz-Núñez
Keyword(s):  
Systematic Review ◽  
Industry 4.0 ◽  
Grey Literature ◽  
Critical Factor ◽  
Developed Countries ◽  
Manufacturing Strategy ◽  
Content Type ◽  
The Public ◽  
Readiness To Adopt

PurposeThis research aims to conduct, to the best of our knowledge, the first systematic review of the implementation of Industry 4.0 in BRICS. This review facilitates the identification of main factors that affect the readiness to adopt Industry 4.0 in BRICS and the role of different agents, such as multinationals, the public sector or educative institutions.Design/methodology/approachKey publications published from 2010 to 2019 have been analysed. A total of 61 papers have been selected from the systematic review.FindingsThree factors of convergence of BRICS to developed economies in terms of Industry 4.0 are identified: (1) the public initiatives that can also result in the attraction of talent from developed countries to BRICS; (2) the role of multinationals and (3) the implication of educational institutions.Research limitations/implicationsThis review has some limitations. First, some grey literature, such as reports from non-governmental organisations and front-line practitioners' reflections, were not included. Second, only research studies in English were reviewedPractical implicationsThe heterogeneity of BRICS amongst themselves affects the implementation of Industry 4.0 policies. Therefore, public policies should differ among countries to achieve the different readiness of companies within each country. Industry 4.0 cannot be understood as a manufacturing strategy against delocalisation, as emerging countries, such as BRICS, are also aware of the potential of automation.Originality/valueBased on a systematic review, this article shows that the strategy created by Germany to increase industrial productivity has been also introduced in BRICS countries as a critical factor to improve their competitiveness.

The Emerging Role of Neutrophil to Lymphocyte Ratio in Determining Colorectal Cancer Treatment Outcomes: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 21 (12) ◽  
pp. 3938-3946 ◽  
Author(s):  
George Malietzis ◽  
Marco Giacometti ◽  
Robin H. Kennedy ◽  
Thanos Athanasiou ◽  
Omer Aziz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Cancer Treatment ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Colorectal Cancer Treatment

scholarly journals A Systematic Review of Hospital Efficiency and Productivity Studies: Lessons from Australia, UK and Canada.

2020 ◽  
Author(s):  
Bonnie Eklom ◽  
Emily Callander
Keyword(s):  
Systematic Review ◽  
United Kingdom ◽  
Health System ◽  
Grey Literature ◽  
Health Sector ◽  
Performance Measure ◽  
Full Time ◽  
The United Kingdom ◽  
Google Search ◽  
Efficiency And Productivity

Abstract BackgroundAgeing populations, more expensive technology, growing rates of chronic disease and increasing consumer expectations are expected to lead to increased demand for health services and a rise in health expenditure within Australia. Productivity and efficiency analysis of Australia’s health system could provide valuable insight into the performance of the health system and assist stakeholders to reduce unnecessary growth in public hospital expenditure. This review describes efficiency and productivity analyses of hospitals in Australia, Canada and the United Kingdom. Methods We conducted a systematic literature review of efficiency and productivity analyses of hospitals in Australia, Canada and the United Kingdom. The search was conducted in two stages; (1) a search of the grey literature using a Google search engine; and (2) a traditional systematic review method search of academic databases. It is uncommon for grey literature to have abstracts, therefore, executive summaries, table of contents or subheadings were screened. Titles and Abstracts of journal articles were screened. DiscussionWithin Australia and key comparator nations, the number of efficiency and analysis studies is small. There is no clear consensus on the most suitable analysis technique to measure efficiency and productivity of hospitals. However, selection of inputs is similar across all studies identified in this review, consisting of measures of labour (most commonly relating to full time equivalent employees), goods and services (e.g. purchased consumables, such as drugs), and capital. Similarly, the majority of studies struggled to identify output measures that could capture improvements in patient outcomes, a key performance measure for any hospital. Instead, most studies utilised proxy measures relating to hospital throughputs (number of separations) or population health measurements. Of note, only one study demonstrated active engagement with the health sector in study development. Conclusion There is considerable scope for the further development of efficiency and productivity analysis techniques that can adequately capture relevant production factors, allow for robust comparisons across hospitals and time periods and which meaningfully engage with the health sector to inform improvements in efficiency and productivity.

Role of Nanoparticles in Cancer Therapy

2022 ◽  
pp. 363-388
Author(s):  
Zeeshan Ahmad Bhutta ◽  
Ayesha Kanwal ◽  
Ambreen Ashar ◽  
Moazam Ali ◽  
Ashar Mahfooz ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Cancer Treatment ◽  
Genetic Material ◽  
Modern Medicine ◽  
Cancer Treatments ◽  
Delivery Methods ◽  
Anticancer Drug Delivery ◽  
Scientific Fields

The rapid growth of nanotechnology towards the development of nanomedicines has improved cancer treatment. Nanomedicine provides the opportunity to implement complex and targeted multifunctional strategies. Today, nanoparticles (NPs) have many uses in a number of scientific fields. In recent years, it has been repeatedly reported that NPs hold a significant place in the regulation of modern medicine by implementing a varying number of clinical approaches like drug carrying substances, genetic material delivery to tumors, as well as in radiography as a contrast media agent. Various nanomaterials based on organic, inorganic, lipid or glycan compounds, and synthetic polymers have been used to develop and improve new cancer treatments. In this chapter, the authors discussed the role of NPs in cancer treatment among various anticancer drug delivery methods.

scholarly journals Nanoparticle-mediated synergistic chemoimmunotherapy for tailoring cancer therapy: recent advances and perspectives

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rafieh Bagherifar ◽  
Seyed Hossein Kiaie ◽  
Zahra Hatami ◽  
Armin Ahmadi ◽  
Abdolvahid Sadeghnejad ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cancer Treatment ◽  
First Line ◽  
Recent Advances ◽  
Pros And Cons ◽  
Immunomodulation Effect

AbstractNowadays, a potent challenge in cancer treatment is considered the lack of efficacious strategy, which has not been able to significantly reduce mortality. Chemoimmunotherapy (CIT) as a promising approach in both for the first-line and relapsed therapy demonstrated particular benefit from two key gating strategies, including chemotherapy and immunotherapy to cancer therapy; therefore, the discernment of their participation and role of potential synergies in CIT approach is determinant. In this study, in addition to balancing the pros and cons of CIT with the challenges of each of two main strategies, the recent advances in the cancer CIT have been discussed. Additionally, immunotherapeutic strategies and the immunomodulation effect induced by chemotherapy, which boosts CIT have been brought up. Finally, harnessing and development of the nanoparticles, which mediated CIT have expatiated in detail.

Sign in / Sign up

Export Citation Format

Share Document