BACKGROUND: Breast cancer (BC) is a leading cause of morbidity, mortality, and disability for women, worldwide. There is substantial variation in treatment outcomes, which is function of multiple variables, including access to treatment. Treatment standards can promote quality and improve survival; thus, their development should be a priority for the cancer control planning.METHODS: We extracted the guidelines for the treatment of BC from a systematic review of the literature. We evaluated the development process, the methodology and the recommendations formulated, and surveyed the country resource stratification. Metrics of health system capacity were selected, to study the guidelines context- appropriateness.RESULTS: We analysed 49 distinct guidelines for BC, mostly in English language (n=23), developed in upper-middle and high-income countries of the European and American Regions (n=39). A resource-stratified approach was identified in a quarter of the guidelines (n=11), mostly from resource- constrained settings. Only a half of the guidelines reached a gender balance of the authorship and 10.2% were based on a multidisciplinary steering committee. A number of efforts and solutions of resource adaptations were recognized, mostly in low- and middle-income countries. Overall, the national guidelines appeared not enough sensitive of the local health system capacity in formulating recommendations, with possible exception for the radiation therapy availability.CONCLUSION: This global landscape of treatment standards for BC demonstrates that the majority are not context appropriate. Research on the formulation of cancer treatment standards is highly warranted, along with novel platforms for developing and disseminating resource-appropriate guidance.

The global landscape of treatment standards for breast cancer / D. Trapani, J. Yves Douillard, E.P. Winer, H. Burstein, L. Anne Carey, J. Cortes, G. Lopes, J.R. Gralow, W.J. Gradishar, N. Magrini, G. Curigliano, A.M. Ilbawi. - In: JOURNAL OF THE NATIONAL CANCER INSTITUTE. - ISSN 0027-8874. - (2021). [Epub ahead of print]

The global landscape of treatment standards for breast cancer

D. Trapani
Primo
;
G. Curigliano
Penultimo
Conceptualization
;
2021

Abstract

BACKGROUND: Breast cancer (BC) is a leading cause of morbidity, mortality, and disability for women, worldwide. There is substantial variation in treatment outcomes, which is function of multiple variables, including access to treatment. Treatment standards can promote quality and improve survival; thus, their development should be a priority for the cancer control planning.METHODS: We extracted the guidelines for the treatment of BC from a systematic review of the literature. We evaluated the development process, the methodology and the recommendations formulated, and surveyed the country resource stratification. Metrics of health system capacity were selected, to study the guidelines context- appropriateness.RESULTS: We analysed 49 distinct guidelines for BC, mostly in English language (n=23), developed in upper-middle and high-income countries of the European and American Regions (n=39). A resource-stratified approach was identified in a quarter of the guidelines (n=11), mostly from resource- constrained settings. Only a half of the guidelines reached a gender balance of the authorship and 10.2% were based on a multidisciplinary steering committee. A number of efforts and solutions of resource adaptations were recognized, mostly in low- and middle-income countries. Overall, the national guidelines appeared not enough sensitive of the local health system capacity in formulating recommendations, with possible exception for the radiation therapy availability.CONCLUSION: This global landscape of treatment standards for BC demonstrates that the majority are not context appropriate. Research on the formulation of cancer treatment standards is highly warranted, along with novel platforms for developing and disseminating resource-appropriate guidance.
UN Sustainable Development Goals; breast cancer guidelines; cancer prioritization; global oncology; universal health coverage
Settore MED/06 - Oncologia Medica
27-gen-2021
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/825182
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