scholarly journals Breast Cancer in West Java: Where Do We Stand and Go?

2020 ◽  
Vol 14 (3) ◽  
pp. 91
Author(s):  
Yohana Azhar ◽  
Hasrayati Agustina ◽  
Maman Abdurahman ◽  
Dimyati Achmad
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Cancer Care ◽  
Breast Conserving Surgery ◽  
Treatment Needs ◽  
West Java ◽  
Middle Income ◽  
Aggressive Approach ◽  
Care Pattern ◽  
Care Patterns

Background: Breast cancer is the most common cancer in Indonesia, a low-middle income country in Southeast Asia. We provide a regional hospital-based cancer registry of the central hospital in West Java, Indonesia. This study aims to characterize the presentation, diagnosis, evaluation, and management of breast cancer; to develop a regional breast cancer registry in West Java to monitor cancer care patterns; to evaluate cancer treatment outcomes.Methods: The data were collected from the medical records deposited in the Hasan Sadikin General Hospital Information System. The team has been contracted to operate the registry & organize an advisory board to standardize definitions of coding terminology of the registry’s reporting system and to monitor the cancer care pattern. Data validation was conducted by a team in the cancer registry, consisting of health officers, pathologists, and registrars. Data management and analysis were conducted by the cancer registry team.Results: A total of 913 women diagnosed with breast cancer, from January 2014 until December 2018, were studied. The median age was 49.5 years old. The initial diagnosis was at the age of 42.4 years old on average. About 64.5% were diagnosed with stage-3 and -4 cancers, and 75.1% had undergone a mastectomy, of which 47.3% of the intent was palliative. Of those who have hormonal receptors, only 26.9% were positive, and 36.5% were not assessed for immunohistochemistry evaluation. Inappropriate surgical management of breast cancer was common at the community level, which included indiscriminate diagnostic lumpectomy (21.9%), incomplete mastectomy and omission, or suboptimal lymph node axillary clearance (47.4%). Only 3.0% of patients received breast-conserving surgery and were treated with mastectomy and reconstruction. Conclusions: Breast cancer in West Java is often recognized at the late stage. Treatment was suboptimal, leading to poor survival. A more aggressive approach to early detection and treatment needs to be developed to improve the outcomes of this potentially curable disease.

Use of cancer registry data for research on patterns of breast cancer care of individuals with Medicaid insurance

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 6021-6021 ◽  
Author(s):  
R. T. Anderson ◽  
F. T. Camacho ◽  
R. Balkrishnan ◽  
E. Levine ◽  
G. Kimmick ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Cancer Care ◽  
Registry Data ◽  
Breast Cancer Care ◽  
Cancer Registry Data

Quality of care for breast cancer patients in Japan: An analysis of the Japanese Breast Cancer Registry

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6547-6547
Author(s):  
H. Mukai ◽  
T. Higashi ◽  
T. Iwase ◽  
T. Sobue
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Registry ◽  
Cancer Care ◽  
Breast Cancer Patients ◽  
Breast Cancer Care ◽  
Recommended Care ◽  
Adherence Score ◽  
Breast Cancer Registry

6547 Background: In Japan, growing concern that patients do not receive optimum care led to the enactment of the Cancer Control Act in 2006, which mandates the government to undertake initiatives in ensuring the quality of cancer care. Here, we evaluated the current status of breast cancer care in Japan using process-of-care quality indicators (QIs) for breast cancer care. Methods: Combining clinical evidence and expert opinion, we developed 45 QIs covering the continuum of breast cancer care from initial evaluation to follow-up. Each QI describes standards of a particular aspect of care, and its score is calculated as the percentage of applicable patients who received the recommended care (adherence score). Of the 45 QIs, 7 could be scored using data in the Japanese Breast Cancer Registry, which covers about 40% of all Japanese breast cancer patients and has been continuously maintained since 1975. Results: The study population included 15,227 patients registered by 224 facilities in 2005. On average, patients received 72.1% of recommended care. However, substantial variation in adherence was seen across QIs (21–98%). Adherence score was less than 85% in five of seven QIs. Variation across facilities was observed in six QIs. Conclusions: The quality of breast cancer care in Japan has room for improvement in many aspects of care. Although the amount of data in the cancer registry suitable for quality assessment is limited, it is useful in detecting quality problems. [Table: see text] No significant financial relationships to disclose.

scholarly journals The Feasibility and Performance of the Patient Navigation Programme in Improving Breast Cancer Care in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 95s-95s
Author(s):  
M. Jaganathan ◽  
N.H. Zainal ◽  
N. Rajaram ◽  
T. Soo Hwang ◽  
M.Y. Abdul Wahab
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Patient Navigation ◽  
Poor Adherence ◽  
Adherence To Treatment ◽  
Breast Cancer Care ◽  
Middle Income ◽  
Treatment Delays ◽  
And Performance ◽  
The Impact

Background: Breast cancer is the most common cancer in Malaysia and it is anticipated that incidence will increase by 49% from 2012 to 2025. Unfortunately, survival remains poor because of late presentation and poor adherence to evidence-based medicine. Barriers to early presentation include inadequate knowledge about the disease, financial issues, negative influence of relatives and perceived poor quality of care and services in state-run hospitals. Poor adherence to treatment is also a common struggle, and is further exacerbated by the use of traditional, alternative healing methods. While patient navigation (PN) programs have been shown to improve breast cancer outcomes in the US, its implementation and performance in low and middle income countries is not well studied. Aim: We sought to determine the impact of a PN program in reducing treatment delays and improving adherence to treatment and patient satisfaction, as well as to evaluate the barriers faced by women seeking breast cancer care in Malaysia. Methods: We established a nurse-led patient navigation center at a secondary government hospital in Klang. This clinical team involved the surgery, pathology, radiology and nursing departments and provided patient-centered care, including patient tracking and call reminder systems, family counseling, health education and decision aids. The community team involved a Patient Navigator Program Coordinator and a Community Navigator. We compared treatment delays and adherence to treatment between navigated patients and patients registered in the year prior to the PN program. We used Student t-tests and Pearson χ2 or Fisher's Exact tests to compare timeliness between navigated patients and patients registered in the year prior. Results: Of the 136 Malaysian women enrolled in the PNP in 2015, 48.9% were diagnosed with advanced disease (stage 3 or 4). Women with advance disease had a lower median monthly household income compared with women with early disease (USD $350 vs $540, P = 0.023). Women with advance disease were also less likely to have personal transportation to the hospital (36.4% vs 56.5%, P = 0.048). Compared with the year before PN, more navigated patients underwent mammography within 7 days of their first visit (96.4% vs 74.4%, P < 0.001) and received their diagnosis within 14 days of their first visit (80.0% vs 58.5%, P < 0.001). The proportion of women who met timeliness to treatment initiation was similar for navigated patients and patients in the year prior. The proportion of defaulters were marginally lesser among navigated patients compared with the year prior (4.4% vs 11.5%, P = 0.048). Conclusion: We found that integrating PN within a breast clinic of a middle income country is feasible, and in the long run, could improve outcomes for breast cancer patients. Long-term follow-up is needed to assess the impact of the PN program on improving treatment completion and survival.

scholarly journals Validity of Cancer Registry Data for Measuring the Quality of Breast Cancer Care

2002 ◽  
Vol 94 (11) ◽  
pp. 835-844 ◽  
Author(s):  
J. L. Malin ◽  
K. L. Kahn ◽  
J. Adams ◽  
L. Kwan ◽  
M. Laouri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Cancer Care ◽  
Registry Data ◽  
Breast Cancer Care ◽  
Cancer Registry Data

scholarly journals Closing the global cancer divide- performance of breast cancer care services in a middle income developing country

BMC Cancer ◽  
2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Gerard CC Lim ◽  
◽  
Emran N Aina ◽  
Soon K Cheah ◽  
Fuad Ismail ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Developing Country ◽  
Cancer Care ◽  
Breast Cancer Care ◽  
Middle Income ◽  
Care Services

scholarly journals What If All Patients with Breast Cancer in Malaysia Have Access to the Best Available Care: How Many Deaths Are Avoidable?

2017 ◽  
Vol 9 (8) ◽  
pp. 32 ◽  
Author(s):  
G. F. Ho ◽  
N. A. Taib ◽  
R. K. Pritam Singh ◽  
C. H. Yip ◽  
M. M. Abdullah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Safety Net ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Term Survival ◽  
Middle Income ◽  
Avoidable Deaths ◽  
Low Middle Income Countries ◽  
Under Performing

BACKGROUND: Cancer is a leading cause of death in the world and the fourth leading cause in Malaysia. A widening disparity in cancer burden has emerged between high and low-middle income countries. A similar disparity due to differential access to cancer care between affluent and deprived groups is likely to exist within developing country too. We assess this inequality by estimating the number of deaths due to cancer that would be avoidable if all patients had access to the best available care in Malaysia, a high middle income country.METHODS: The number of avoidable deaths is the difference between the number of deaths estimated by GLOBOCAN12 for Malaysia (which is consistent with published estimates on cancer survival), and the expected number of deaths if all patients with Breast Cancer (BC) had experienced the age-ethnic-stage specific survival outcomes observed in a leading private cancer centre in Malaysia. Data on age-ethnic-stage composition of the general BC population were from local cancer registry and public hospitals providing safety net cancer services.FINDINGS: Of the 2312 excess deaths due to BC, 2048 (88%) were avoidable. Of these avoidable deaths, 1167 (57%) were attributable to late stage presentation while 881 (43%) were due to lack of access to optimal treatment. Sensitivity analyses however show that the 88% avoidable deaths may be as low as 50%, taking into account differences in socio-economic status, over-diagnosis and lack of very long term survival data.INTERPRETATION: The huge number of avoidable deaths highlights the high cancer mortality rate among the deprived and the vast disparity in access to cancer care between the rich and poor within Malaysia, which mirrors the global cancer divide between rich and poor countries.Cancer care system that deliver such disastrous and inequitable outcomes is clearly under-performing. It is in urgent need of reform.

scholarly journals Integration of breast cancer care in a middle-income country: learning from Suandok Breast Cancer Network (SBCN)

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Imjai Chitapanarux ◽  
Wimrak Onchan ◽  
Panchaporn Wongmaneerung ◽  
Areewan Somwangprasert ◽  
Nongnuch Bunyoo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Care ◽  
Breast Cancer Patients ◽  
Breast Cancer Care ◽  
Chiang Mai ◽  
Northern Thailand ◽  
Middle Income ◽  
Cancer Network

Abstract Background Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. In 2002 the urgency of the situation prompted Maharaj Nakorn Chiang Mai Hospital to initiate the Suandok Breast Cancer Network (SBCN). Methods The SBCN is a not-for-profit organization in the university hospital which serves as a training and education center and provides highly specialized medical care for patients in Chiang Mai and in 5 provinces of northern Thailand, with the key mission of improving breast cancer care. The short-term goal was to overcome the barriers to engagement with breast cancer and its treatment and the long-term goal was to increase the overall survival rate of breast cancer patients in our region. Results We enrolled breast cancer patients treated at Maharaj Nakorn Chiang Mai Hospital between January 2006 and December 2015 and divided into 2 cohorts: 1485 patients who were diagnosed from 2006 to 2009 (cohort 1: early implementation of SBCN) and 2383 patients who were diagnosed from 2010 to 2015 (cohort 2: full implementation of SBCN). Criteria to measure improved cancer waiting time (CWT) would include: time to diagnosis, time to surgery, and time to radiotherapy. The 5-year overall survival (OS) of the cohort 2 was higher than that in cohort 1, at 73.8 (72.0–75.5) compared to 71.5 (69.2–73.7) (p-value = 0.03). Conclusions Reasons behind the success of project include the uniformity of care encouragement, service network development and timely access to each step of breast cancer management. The model used in SBCN could be adopted as a learning guide to improve healthcare access and outcome for breast cancer patients in low- to middle-income countries.

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