Advancing access and equity: the vision of a new generation in cancer control

• Published in: The lancet oncology 2017-02, Vol.18 (2), p.172-175
• Main Authors: Ilbawi, André M, Ayoo, Elizabeth, Bhadelia, Afsan, Chidebe, Runcie C W, Fadelu, Temidayo, Herrera, Cristian A, Htun, Han Win, Jadoon, Nauman Arif, James, Oluwafunmilola W, May, Leana, Maza, Mauricio, Murgor, Mellany, Nency, Yetty M, Oraegbunam, Chukwuma, Pratt-Chapman, Mandi, Qin, Xiaojian, Rodin, Danielle, Tripathi, Neha, Wainer, Zoe, Yap, Mei Ling
• Format: Article
• Language: English
• Subjects: Cervical cancer; Civil society; Decades; Equity; Forecasting; Gays & lesbians; Gender identity; Global Health - trends; Health Equity - organization & administration; Health Equity - trends; Health Services Accessibility - organization & administration; Health Services Accessibility - trends; Health Services Needs and Demand - trends; Healthcare Disparities - organization & administration; Healthcare Disparities - trends; Hematology, Oncology and Palliative Medicine; Humans; Immunization; Leadership; Medical Oncology - organization & administration; Medical Oncology - trends; Needs Assessment - trends; Neoplasms - mortality; Neoplasms - therapy; Palliative care; Patients; Primary care; Radiation therapy; Social networks; Tobacco; Transgender persons
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(17)30041-4

Only recently, for example, have lesbian, gay, bisexual, and transgender (LGBT) individuals started to be included in clinical and research databases that previously lacked sexual orientation and gender identity data.8 Similarly, indigenous populations are marginalised by data that are inadequate to improve access and establish best practices.\n We commit to working with cancer organisations globally, regionally, and nationally to invest our knowledge, experience, and passion to realise the vision of equity in cancer care. Current reality Significantly reduce tobacco use 1·1 billion people in the world use tobacco, nearly 80% of whom live in LMICs; tobacco kills around 6 million people each year and nearly half its users over their lifetime3 Achieve healthy living and physical activity Obesity is a significant risk factor for cancer development; in 2014, more than 1·9 billion adults were overweight4 Target near complete elimination of cervical cancer deaths Each year nearly 300 000 women die from cervical cancer, mostly in LMICs; the disease that can be prevented with vaccination and managed effectively with screening1 Reduce frequency of late diagnosis and improve integrated, people-centred care Poor symptom knowledge, fatalistic beliefs, and emotional barriers result in delayed presentation and worse outcomes, especially in vulnerable socioeconomic groups;5 fragmented services, in which patients can see numerous health providers, also result in poor care Improve access to cancer care A substantial proportion of patients with cancer do not have access to radiotherapy and as few as 25% have access to safe, timely, and affordable cancer surgery6 Protect individuals, families, and communities from financial catastrophe The cost per month for a new cancer drug has increased 40%, or US $5900 (inflation adjusted), to a total cost of $20 700 over the past decade in the USA7 Promote equity in cancer outcomes across borders and within communities Childhood cancer survival rates are about 80% in high-income countries and might be as low as 10% in some LMICs;1 fractured care in childhood cancers and prohibitive costs results in treatment abandonment; vulnerable populations, such as LGBT people, have compromised access to cancer care and monitoring of outcomes8 Advance supportive care services for patients with cancer and their families One-third of people with a history of cancer report limitations in activities of daily living, and cancer survivors in all age group