Modeling studies suggest that global demand for cancer surgery will increase by 52% by 2040, with underfunded low-income countries being the biggest burden.
The second study shows that cancer surgery results are much worse in low-income countries, quadrupling the risk of death after stomach or stomach surgery. Colorectal cancer..
Together, the study emphasizes the urgent need to strengthen resources and capacity to help meet the needs of poorer countries, the authors agree.
“Policymakers around the world need to balance the investment in early detection and treatment of cancer with the simultaneous improvement of safe perioperative care. Without these investments, mortality in cancer control The increase will not be fully realized, “they warn.
Increased demand
In modeling research Published online January 21st Lancet Oncology, Researchers estimated the demand for cancer surgery in 183 countries between 2018 and 2040.
Overall, cancer surgery cases increase from 9.1 million to 13.8 million (52% increase), according to the analysis. Caseloads are expected to more than double in 34 low-income countries.
In addition, it is estimated that there will be a shortage of 199,000 surgeons and 87,000 anesthesiologists worldwide. These workforce levels are 26% and 24% below optimal values, respectively.
Again, these shortages were the largest in low-income countries. In these countries, the number of surgeons and anesthesiologists needs to be more than doubled to meet the expected demand in 2040. The authors say the numbers need to be increased by nearly 400% and 550%, respectively, to match the current levels of high-income countries.
The author, Sathira Kasun Perera, MSc, a collaboration for cancer outcome research and evaluation at the University of New South Wales in Sydney, Australia, said, “The gap widens without swift action to secure the human resources needed for cancer. It’s likely. ” Surgery is well planned, especially in countries with social and economic transitions. “
Worse results in low-income countries
The second study was conducted by the GlobalSurg Collaborative and National Institute for Health Research Global Health Research Unit on Global Surgery. Published online January 21 The lancet.
It provides a unique prospective dataset of patients experiencing breasts, colorectal polyps, and stomach cancer Surgery around the world, “says the author.
The study enrolled 15,958 patients from 428 hospitals in 82 countries between April 2018 and January 2019.
Researchers found that patients with colorectal cancer who underwent surgery in low- and middle-income countries died at a much higher rate than patients in high-income countries (63 of 905 patients, 4142). 94 patients, adjusted odds ratio. Mortality. [aOR], 4.59). In addition, patients in high- and middle-income countries were about twice as likely to die as patients in high-income countries (47 of 1102 patients, aOR, 2.06).
Patients in low-income countries who had surgery for gastric cancer had a higher risk of death than patients in high-income countries.Patients did not see such a difference breast cancer..
The study also found that the chances of dying within 30 days of major surgical complications were 6 times higher in low-income and low- and middle-income countries and nearly 4 times higher in high- and middle-income countries compared to high-income countries. I found it expensive. (AOR, 6.15 and 3.89, respectively). The authors say the difference was not solely due to the stage of the cancer at the time of publication.
Future studies should focus on detailed characterization of the perioperative care process and implementation of strategies to reduce the incidence of complications and save patients from complications when they occur. They conclude.
“Enhanced this ability to save patients from complications may help reduce deaths after cancer surgery in low- and middle-income countries,” said the corresponding author, Global Surgery at the British National Institutes of Health. Ewen M. Harrison, Doctor of Medicine, Global Health Research Unit, added. University of Edinburgh, Edinburgh, United Kingdom, Press Statement.
Modeling research was funded by the University of New South Wales and the Global Challenge Research Fund of the UK Institute for Research and Technology Innovation. The cancer outcome study was funded by the National Institute of Health. Perella and Harrison do not disclose the relevant financial relationship.
Lancet onco. Published online on January 21, 2021. Overview
The lancet. Published online on January 21, 2021. Full text
Sharon Worcester is a reporter for MDedge News, which is part of the Medscape Professional Network.
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