scholarly journals Places & Spaces: A Critical Analysis of Cancer Disparities and Access to Cancer Care Among First Nations Peoples in Canada

2020 ◽  
Vol 2 (2) ◽  
pp. 104-123
Author(s):  
Tara Horrill ◽  
Josee Lavoie ◽  
Donna Martin ◽  
Annette Schultz
Keyword(s):  
First Nations ◽  
Cancer Care ◽  
Geographical Location ◽  
Ways Of Knowing ◽  
Health Inequities ◽  
Cancer Disparities ◽  
Cancer Services ◽  
Poor Access ◽  
Increases In Risk ◽  
Experience Difficulty

Despite advancements in research and medicine, health inequities and disparities among First Nations peoples (FN) in Canada are well documented and continue to grow. Once virtually unheard of, cancer now is a leading cause of death among FN. Many factors contribute to cancer disparities, but FN face unique challenges in accessing healthcare. In this critical review and analysis, we explore potential links between cancer disparities and poor access to cancer care among FN. Research suggests FN experience difficulty accessing cancer services in several ‘places’ of care, including screening, diagnosis, treatment, survivorship and palliative care. Furthermore, there are notable ‘spaces’ or gaps both within and between these ‘places’ of care likely contributing to cancer disparities among First Nations. Gaps in care result from jurisdictional ambiguities, geographical location, unsafe social spaces, and marginalization of FN ways of knowing, and can be linked to colonial and neocolonial policies and ideologies. By drawing attention to these broader structural influences on health, we aim to challenge discourses that attribute growing cancer disparities among FN in Canada solely to increases in ‘risk factors’.

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

scholarly journals Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

2021 ◽  
pp. 1-11
Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan
Keyword(s):  
Cancer Care ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
System Level ◽  
Care Continuum ◽  
Cancer Services ◽  
Number Of Patients ◽  
Prevention Programmes ◽  
Screening And Prevention ◽  
The Impact

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

scholarly journals Cancer services in Sri Lanka: current status and future directions

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Umesh Jayarajah ◽  
Anuruddha M. Abeygunasekera
Keyword(s):  
Sri Lanka ◽  
Cancer Prevention ◽  
Systemic Therapy ◽  
Cancer Care ◽  
Current Status ◽  
Main Body ◽  
Prevention Measures ◽  
High Quality Research ◽  
Screening Programs ◽  
Cancer Services

Abstract Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.

scholarly journals The Australian Youth Cancer Service: Developing and Monitoring the Activity of Nationally Coordinated Adolescent and Young Adult Cancer Care

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2675
Author(s):  
Pandora Patterson ◽  
Kimberley R. Allison ◽  
Helen Bibby ◽  
Kate Thompson ◽  
Jeremy Lewin ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Young Adults ◽  
Cancer Care ◽  
Young Patients ◽  
Adolescents And Young Adults ◽  
Adolescent And Young Adult ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Activity Data ◽  
Cancer Services

Adolescents and young adults (aged 15–25 years) diagnosed with cancer have unique medical and psychosocial experiences and care needs, distinct from those of paediatric and older adult patients. Since 2011, the Australian Youth Cancer Services have provided developmentally appropriate, multidisciplinary and comprehensive care to these young patients, facilitated by national service coordination and activity data collection and monitoring. This paper reports on how the Youth Cancer Services have conceptualised and delivered quality youth cancer care in four priority areas: clinical trial participation, oncofertility, psychosocial care and survivorship. National activity data collected by the Youth Cancer Services between 2016–17 and 2019–20 are used to illustrate how service monitoring processes have facilitated improvements in coordination and accountability across multiple indicators of quality youth cancer care, including clinical trial participation, access to fertility information and preservation, psychosocial screening and care and the transition from active treatment to survivorship. Accounts of both service delivery and monitoring and evaluation processes within the Australian Youth Cancer Services provide an exemplar of how coordinated initiatives may be employed to deliver, monitor and improve quality cancer care for adolescents and young adults.

scholarly journals Cancer Disparities and Health Equity: A Policy Statement From the American Society of Clinical Oncology

2020 ◽  
Vol 38 (29) ◽  
pp. 3439-3448 ◽  
Author(s):  
Manali I. Patel ◽  
Ana Maria Lopez ◽  
William Blackstock ◽  
Katherine Reeder-Hayes ◽  
E. Allyn Moushey ◽  
...  
Keyword(s):  
Health Equity ◽  
Cancer Care ◽  
Care Delivery ◽  
Sociodemographic Factors ◽  
Cancer Disparities ◽  
Policy Statement ◽  
Structural Barriers ◽  
Cancer Outcomes ◽  
Research Education ◽  
And Gender

ASCO strives, through research, education, and promotion of the highest quality of patient care, to create a world where cancer is prevented and every survivor is healthy. In this pursuit, cancer health equity remains the guiding institutional principle that applies to all its activities across the cancer care continuum. In 2009, ASCO committed to addressing differences in cancer outcomes in its original policy statement on cancer disparities. Over the past decade, despite novel diagnostics and therapeutics, together with changes in the cancer care delivery system such as passage of the Affordable Care Act, cancer disparities persist. Our understanding of the populations experiencing disparate outcomes has likewise expanded to include the intersections of race/ethnicity, geography, sexual orientation and gender identity, sociodemographic factors, and others. This updated statement is intended to guide ASCO’s future activities and strategies to achieve its mission of conquering cancer for all populations. ASCO acknowledges that much work remains to be done, by all cancer stakeholders at the systems level, to overcome historical momentum and existing social structures responsible for disparate cancer outcomes. This updated statement affirms ASCO’s commitment to moving beyond descriptions of differences in cancer outcomes toward achievement of cancer health equity, with a focus on improving equitable access to care, improving clinical research, addressing structural barriers, and increasing awareness that results in measurable and timely action toward achieving cancer health equity for all.

Indigenous Studies in the United States and Canada

2021 ◽  
Author(s):  
Aubrey Jean Hanson ◽  
Sam McKegney
Keyword(s):  
United States ◽  
Native American ◽  
First Nations ◽  
Indigenous People ◽  
Indigenous Peoples ◽  
Ways Of Knowing ◽  
Indigenous Communities ◽  
The United States ◽  
Literary Studies ◽  
Indigenous Voices

Indigenous literary studies, as a field, is as diverse as Indigenous Peoples. Comprising study of texts by Indigenous authors, as well as literary study using Indigenous interpretive methods, Indigenous literary studies is centered on the significance of stories within Indigenous communities. Embodying continuity with traditional oral stories, expanding rapidly with growth in publishing, and traversing a wild range of generic innovation, Indigenous voices ring out powerfully across the literary landscape. Having always had a central place within Indigenous communities, where they are interwoven with the significance of people’s lives, Indigenous stories also gained more attention among non-Indigenous readers in the United States and Canada as the 20th century rolled into the 21st. As relationships between Indigenous Peoples (Native American, First Nations, Métis, and Inuit) and non-Indigenous people continue to be a social, political, and cultural focus in these two nation-states, and as Indigenous Peoples continue to work for self-determination amid colonial systems and structures, literary art plays an important role in representing Indigenous realities and inspiring continuity and change. An educational dimension also exists for Indigenous literatures, in that they offer opportunities for non-Indigenous readerships—and, indeed, for readers from within Indigenous nations—to learn about Indigenous people and perspectives. Texts are crucially tied to contexts; therefore, engaging with Indigenous literatures requires readers to pursue and step into that beauty and complexity. Indigenous literatures are also impressive in their artistry; in conveying the brilliance of Indigenous Peoples; in expressing Indigenous voices and stories; in connecting pasts, presents, and futures; and in imagining better ways to enact relationality with other people and with other-than-human relatives. Indigenous literatures span diverse nations across vast territories and materialize in every genre. While critics new to the field may find it an adjustment to step into the responsibility—for instance, to land, community, and Peoplehood—that these literatures call for, the returns are great, as engaging with Indigenous literatures opens up space for relationship, self-reflexivity, and appreciation for exceptional literary artistry. Indigenous literatures invite readers and critics to center in Indigeneity, to build good relations, to engage beyond the text, and to attend to Indigenous storyways—ways of knowing, being, and doing through story.

scholarly journals Care of adolescents and young adults with cancer in Asia: results of an ESMO/SIOPE/SIOP Asia survey

ESMO Open ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. e000467 ◽  
Author(s):  
Chi Kong Li ◽  
Rashmi Dalvi ◽  
Kan Yonemori ◽  
Hany Ariffin ◽  
Chuhl Joo Lyu ◽  
...  
Keyword(s):  
Young Adults ◽  
European Society ◽  
Cancer Care ◽  
Online Survey ◽  
Healthy Lifestyle ◽  
Insurance Coverage ◽  
Paediatric Oncology ◽  
Adolescents And Young Adults ◽  
Human Papillomavirus Vaccination ◽  
Cancer Services

BackgroundAdolescents and young adults (AYAs) with cancer require dedicated management encompassing both adult and paediatric cancer services. Following a European survey, the European Society for Medical Oncology, the European Society for Paediatric Oncology and the Asian continental branch of International Society of Paediatric Oncology undertook a similar survey to assess AYA cancer care across Asia.MethodsA link to the online survey was sent to healthcare professionals (HCPs) in Asia interested in AYA cancer care. Questions covered the demographics and training of HCPs, their understanding of AYA definition, availability and access to specialised AYA services, the support and advice offered during and after treatment, and factors of treatment non-compliance.ResultsWe received 268 responses from 22 Asian countries. There was a striking variation in the definition of AYA (median lower age 15 years, median higher age 29 years). The majority of the respondents (78%) did not have access to specialised cancer services and 73% were not aware of any research initiatives for AYA. Over two-thirds (69%) had the option to refer their patients for psychological and/or nutritional support and most advised their patients on a healthy lifestyle. Even so, 46% did not ask about smokeless tobacco habits and only half referred smokers to a smoking cessation service. Furthermore, 29% did not promote human papillomavirus vaccination for girls and 17% did not promote hepatitis B virus vaccination for high-risk individuals. In terms of funding, 69% reported governmental insurance coverage, although 65% reported that patients self-paid, at least partially. Almost half (47%) reported treatment non-compliance or abandonment as an issue, attributed to financial and family problems (72%), loss of follow-up (74%) and seeking of alternative treatments (77%).ConclusionsLack of access to and suboptimal delivery of AYA-specialised cancer care services across Asia pose major challenges and require specific interventions.

scholarly journals Cancer care in Brazil: structure and geographical distribution

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mario Jorge Sobreira da Silva ◽  
Gisele O’Dwyer ◽  
Claudia Garcia Serpa Osorio-de-Castro
Keyword(s):  
Population Size ◽  
Cancer Care ◽  
National Health System ◽  
Geographic Location ◽  
Paediatric Oncology ◽  
National Registry ◽  
Annual Data ◽  
Cancer Services ◽  
Ensure Patient Safety ◽  
Significant Deficit

Abstract Background The organisation and systematisation of health actions and services are essential to ensure patient safety and the effectiveness and efficiency of cancer care. The objective of this study was to analyse the structure of cancer care envisaged in Brazilian norms, describe the types of accreditations of cancer services and their geographic distribution, and determine the planning and evaluation parameters used to qualify the health units that provide cancer care in Brazil. Methods This observational study identified the current organisation of cancer care and other health services that are accredited by Brazil’s national health system (SUS) for cancer treatment as of February 2017. The following information was collected from the current norms and the National Registry of Health Establishments: geographic location, type of accreditation, type of care, and hospital classification according to annual data of the number of cancer surgeries. The adequacy of the number of licensed units relative to population size was assessed. The analysis considered the facilitative or restrictive nature of policies based on the available rules and resources. Results The analysis of the norms indicated that these documents serve as structuring rules and resources for developing and implementing cancer care policies in Brazil. A total of 299 high-complexity oncology services were identified in facilities located in 173 (3.1%) municipalities. In some states, there were no authorised services in radiotherapy, paediatric oncology and/or haematology-oncology. There was a significant deficit in accredited oncology services. Conclusions The parameters that have been used to assess the need for accredited cancer services in Brazil are widely questioned because the best basis of calculation is the incidence of cancer or disease burden rather than population size. The results indicate that the availability of cancer services is insufficient and the organisation of the cancer care network needs to be improved in Brazil.

scholarly journals Service Providers’ Perceptions of Support Needs for Indigenous Cancer Patients in Saskatchewan: A Needs Assessment

2021 ◽  
Author(s):  
Jennifer R. Sedgewick ◽  
Anum Ali ◽  
Andreea Badea ◽  
Tracey Carr ◽  
Gary Groot
Keyword(s):  
Health Care ◽  
Needs Assessment ◽  
First Nations ◽  
Cancer Patients ◽  
Cancer Care ◽  
Service Providers ◽  
Care Service ◽  
Structured Interview ◽  
Patient Navigator ◽  
Care Services

Abstract Background: In Saskatchewan, Canada, Indigenous cancer care services at the municipal, provincial, and federal levels are intended to improve quality care but can result in a complex, fragmented, and multi-jurisdictional health care system. A multi-phase needs assessment project was initiated to document Indigenous cancer care needs. Guided by Indigenous patient partners, clinicians, academics, and policy makers, the present study reflects a needs assessment of Indigenous cancer supports from the perspectives of cancer care service providers.Methods: Qualitative data were collected through three group interviews with 20 service providers for cancer patients and their families at three Saskatchewan cities. Participants included chemotherapy and radiation nurses, social workers, a patient navigator, dieticians, and practicum students. A semi-structured interview guide was used to conduct the sessions to allow for freedom of responses. Data were recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Service providers’ perspectives were categorized into five themes: 1) addressing travel-related issues, 2) logistical challenges, 3) improvements to Indigenous-specific health care supports, 4) cultural sensitivity in health care, and 5) consistency in care. Supports differed for the two Indigenous groups, First Nations and Métis. Service providers made recommendations regarding how needs could be met. They saw language translation providers and Elder supports as important. Travel recommendations included medical taxis accommodating for more breaks to alleviate the uncomfortable side effects of cancer treatment and Indigenous-specific accommodations be provided. These recommendations aligned with supports that are available in four other Canadian provinces.Conclusions: These results identified gaps in supports and outlined recommendations to address barriers to cancer care from the perspectives of service providers. These recommendations may inform evidence-based health system interventions for Indigenous cancer patients and ultimately aim to improve cancer care services, quality of life, and health outcomes of Indigenous patients throughout their cancer journey.

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