Breast Cancer in Latin America: A Map of the Disease in the Region

2018 ◽  
pp. 451-456 ◽  
Author(s):  
Eduardo Cazap
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Latin America ◽  
Urban Areas ◽  
Access To Health Care ◽  
Cancer Control ◽  
Public Health Problem ◽  
The United States ◽  
High Morbidity ◽  
Patient Organizations

In the next few decades, breast cancer will become a leading global public health problem as it increases disproportionately in low- and middle-income countries. Disparities are clear when comparisons are made with rates in Europe and the United States, but they also exist between the countries of the region or even within the same country in Latin America. Large cities or urban areas have better access and resource availability than small towns or remote zones. This article presents the status of the disease across 12 years with data obtained through three studies performed in 2006, 2010, and 2013 and based on surveys, reviews of literature, patient organizations, and public databases. The first study provided a general picture of breast cancer control in the region (Latin America); the second compared expert perceptions with medical care standards; and the third was a review of literature and public databases together with surveys of breast cancer experts and patient organizations. We conclude that breast cancer is the most frequent cancer and kills more women than any other cancer; we also suggest that aging is the principal risk factor, which will drive the incidence to epidemic levels as a result of demographic transition in Latin America. The economic burden also is large and can be clearly observed: in countries that today allocate insufficient resources, women go undiagnosed or uncared for or receive treatment with suboptimal therapies, all of which results in high morbidity and the associated societal costs. The vast inequities in access to health care in countries translates into unequal results in outcomes. National cancer control plans are the fundamental building block to an organized governance, financing, and delivery of health care for breast cancer.

scholarly journals Choosing wisely in cancer control across Canada—a set of baseline indicators

2017 ◽  
Vol 24 (3) ◽  
pp. 201 ◽  
Author(s):  
K. Tran ◽  
R. Rahal ◽  
S. Fung ◽  
G. Lockwood ◽  
C. Louzado ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Cancer Care ◽  
Practice Patterns ◽  
Cancer Control ◽  
The United States ◽  
Choosing Wisely ◽  
Treatment Practices ◽  
Value Based Care

Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada—modelled after Choosing Wisely in the United States—is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question. Here, we present baseline indicator findings about current practice patterns associated with 7 cancer-related recommendations from Choosing Wisely Canada and about the effects of those practices on patients and the health care system.Indicator findings point to substantial variations in cancer system performance between Canadian jurisdictions, most notably for breast cancer screening practices, treatment practices for men with low-risk localized prostate cancer, and radiation therapy practices for early-stage breast cancer and bone metastases. Extrapolating indicator findings to the entire country, it was estimated that 740,000 breast and cervical cancer screening tests were performed outside of the recommended age ranges, and within 1 year of diagnosis, 17,000 patients received treatments that could be low-value. A 15% reduction in the use of the 7 screening and treatment practices examined could lead to multiple benefits for patients and the health care system: 9000 false-positive results and 3000 treatments and related side effects could be avoided, and 4500 hours of linear accelerator capacity could be freed up each year.Interjurisdictional performance variations suggest potential differences in clinical practice patterns in the planning and delivery of cancer control services, and in some cases, in disease management outcomes. Although the cancer screening and treatment practices described might be unnecessary for some patients, it is important to realize that they could, in fact, be necessary for other patients. Further research into appropriate rates of use could help to determine how much cancer care represents overuse of practices that are not supported by evidence or underuse of practices that are supported by evidence.

scholarly journals Delayed Access to Medical Care of Patients with Breast Cancer

2018 ◽  
Vol 6 (11) ◽  
Author(s):  
Kenia Yazmín García Perusquía ◽  
Juan Carlos Paz Bautista
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Developing Countries ◽  
Medical Care ◽  
Access To Health Care ◽  
Public Policies ◽  
Clinical Stage ◽  
Public Health Problem ◽  
Diagnosis And Treatment ◽  
Timely Diagnosis

Breast cancer is a public health problem and it is more frequent in women living in both developed and developing countries, so it is important to identify the factors associated with delayed access to health care and to implement public policies for a timely diagnosis and treatment. The objective of this review is to collect existing information on breast cancer, its definition, classification, and to identify socio-structural factors of health care services that are associated with delayed medical care that negatively affects in clinical nationalization and therefore a 5-year survival, besides the need for further research related to this topic. Timely diagnosis and therapy for patients with breast cancer require the modification and implementation of current public policies in order to contribute to the reduction of mortality, especially in developing countries, since it has not only an economic impact but also a personal, social and family impact. Late diagnosis and treatment of breast cancer have been associated with a reduced survival period due to the clinical stage of the diagnosis in which a delay of more than three months was identified related to delays in the patient and not only by the lack of identification of signs and symptoms, but also by the lack of human resources and infrastructure.

scholarly journals Female Breast Cancer in Suriname: Pathways to Treatment—A Patient’s Perception

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Euridice R. Irving ◽  
Dennis R. A. Mans ◽  
Els Th. M. Dams ◽  
Maureen Y. Lichtveld
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Access To Health Care ◽  
Early Stage ◽  
Diagnosis And Treatment ◽  
Related Factors ◽  
Entire Interval ◽  
Early Stage Disease ◽  
Resource Setting ◽  
Stage Disease

PURPOSE Delays across the entire cancer care continuum are not uncommon. This cross-sectional study explored the health care trajectories of Surinamese women with breast cancer and identified predictors of timely diagnosis and treatment initiation. METHODS One hundred women age 30 years or older who were newly diagnosed with breast cancer in 2017 to 2018 were recruited from all 4 hospitals in Paramaribo. Data on their demographics, lifestyle, reproductive and medical history, health status, and family history of breast cancer and other malignancies were collected using a validated semistructured questionnaire. Using Anderson’s Model of Pathways to Treatment, we defined a patient interval (from detection to first consultation), diagnostic interval (from consultation to histopathologic diagnosis), and treatment interval (from diagnosis to first treatment). Log-transformed data were analyzed using linear regression, and variables with P ≤ .05 were considered statistically significant predictors of intervals. RESULTS All participants had health insurance and access to health care. Eighty-five percent of patients presented with early-stage disease. Ninety percent of patients had self-detected their disease, with 70% finding a lump. Average age was 55.6 years (± 11.8 years). Median durations of patient, diagnostic, and treatment intervals were 13 days (interquartile, range, 4-63 days), 40 days (IQR, 21-57 days), and 18 days (IQR, 8-38 days), respectively. Median duration of the entire interval was 95 days (IQR, 59-272 days). Patient-related factors associated with the intervals were religion (β = −530; P = .003), being employed (β = 149.4; P = .007), and age 50 years and older (β = −195.8; P = .037). Disease-related factors were lump as first symptom (β = −175.6; P = .038) and late-stage disease at diagnosis (β = 213.5; P = .004). CONCLUSION Given the limited-resource setting, delays in Suriname’s health care can be minimized by programs aimed at increasing breast cancer awareness and education; however, delays may have been underestimated as a result of the over-representation of early-stage disease and recall bias regarding the first symptom detected.

An Assessment of Health Needs in Selected Nigeria Villages

1985 ◽  
Vol 6 (2) ◽  
pp. 161-169 ◽  
Author(s):  
Collins O. Airhihenbuwa
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Cost Of Care ◽  
Health Care Facilities ◽  
High Morbidity ◽  
Community Members ◽  
Care Needs ◽  
Medical Institutions ◽  
Poor Access ◽  
Care Facilities

Two hundred and fifty five heads of households in Iyekuselu District, Bendel State Nigeria, were interviewed. Fifteen villages were randomly selected from the 107 villages that make up the district. There is high morbidity of infectious diseases identified in the study. Limited number of medical professionals and medical institutions present problems of availability of services. This is compounded by high cost of medical services and poor access to health care facilities. The self-perceived health care needs of the heads of households are disease prevention, availability of health services, improved accessibility to health care facilities and reduced cost of care. There is a strong need for health education programs in these villages. This should be attempted with the cooperation of community members, so as to attain the goal of promoting health and preventing diseases.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

Surgical Pathology–Based Outcomes Assessment of Breast Cancer Early Diagnosis

2001 ◽  
Vol 125 (3) ◽  
pp. 325-331
Author(s):  
Raouf E. Nakhleh ◽  
Richard J. Zarbo
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
The United States ◽  
Surgical Pathology ◽  
Detection Methods ◽  
Mortality Data ◽  
Breast Cancers ◽  
Improvement Program ◽  
Clinical Method

Abstract Objective.—To develop breast cancer outcomes data relating pathologic tumor variables at diagnosis with clinical method of detection. Design.—Anatomic pathologists assessed 30 consecutive breast cancers at each institution, resulting in an aggregate database of 4232 breast cancers. Setting.—Hospital-based laboratories from the United States (98%), Canada, Australia, and Belgium. Participants.—One hundred ninety-nine laboratories in the 1999 College of American Pathologists Q-Probes voluntary quality improvement program. Main Outcome Measures.—Pathologic variables indicative of favorable outcomes included percentage of carcinomas detected at the in situ stage, tumors ≤1 cm in diameter, and invasive cancers with lymph nodes negative for metastases. Results.—All outcomes measures, including percent in situ carcinomas (26.9% vs 13.8%), tumor size ≤1 cm (57.8% vs 36.5%), and lymph node–negative status (77.8% vs 64%), were more favorable when tumors were detected by screening mammography (P &lt; .001) compared to all other detection methods. Conclusions.—This study demonstrates an opportunity for pathologists to develop outcomes information of interest to health care organizations, providers, patients, and payers by integrating routine oncologic surgical pathology and clinical breast cancer detection data. Such readily obtained interim outcomes data trended and benchmarked over time can demonstrate the relative clinical efficacy of preventive breast care provided by health care systems long before mortality data are available.

Access to Health Care and Voting Behavior in the United States

2008 ◽  
Vol 19 (3) ◽  
pp. 731-742 ◽  
Author(s):  
Jeanette Kane Ziegenfuss ◽  
Micahel Davern ◽  
Lynn A. Blewett
Keyword(s):  
United States ◽  
Health Care ◽  
Voting Behavior ◽  
Access To Health Care ◽  
The United States ◽  
Access To Health

scholarly journals The Use of Telehealth in School-Based Health Centers

2019 ◽  
Vol 6 ◽  
pp. 2333794X1988419 ◽  
Author(s):  
Hayley Love ◽  
Nirmita Panchal ◽  
John Schlitt ◽  
Caroline Behr ◽  
Samira Soleimanpour
Keyword(s):  
United States ◽  
Health Care ◽  
Public Schools ◽  
Health Care Access ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Centers ◽  
School Based ◽  
School Based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

scholarly journals Medical Education and Training: Building In-Country Capacity at All Levels

2016 ◽  
Vol 34 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Fredrick Chite Asirwa ◽  
Anne Greist ◽  
Naftali Busakhala ◽  
Barry Rosen ◽  
Patrick J. Loehrer
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
National Level ◽  
Cancer Control ◽  
Tertiary Hospital ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Resource ◽  
Medical Education And Training ◽  
Representative Model

Poorly trained workers and limited workforce capacity contribute immensely to barriers in cancer control in low- and middle-income countries (LMICs). Because of an increasing disease burden and the gap in trained personnel, it is critical that LMICs must develop appropriate in-country training programs at all levels to adequately address their cancer-related outcomes. The training in LMICs of cancer health personnel should address priority cancer diseases in the specific country by developing caregivers, trainers, researchers, and administrators at all levels of health care and all cadres of staff, from the community level to the national level. The Academic Model of Providing Access to Health care is a representative model of how a public tertiary hospital like the Moi Teaching and Referral Hospital in an LMIC setting can leverage its resources, collaborate with partners from high-resource countries, and assist in the development of a training center to spearhead a sustainable education program.

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