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Health Advocacy, Inc. : how pharmaceutical funding changed the breast cancer movement
\"Today, most patient groups in Canada are funded by the pharmaceutical industry, raising an important ethical question: Do alliances between patient organizations and corporate sponsors ultimately lead to policies that are counter to the public interest? In this examination of Canada's breast cancer movement from 1990 to 2010, health activist, scholar, and cancer survivor Sharon Batt investigates the relationship between patient advocacy groups and the pharmaceutical industry--and the hidden implications of pharma funding for health policy. Health Advocacy, Inc. dissects the alliances between the companies that sell pharmaceuticals and the individuals who use them, drawing links between neoliberalism and corporate financing, and the ensuing threat to the public health care system. Batt combines archival analysis, interviews with advocacy and industry representatives, and personal observation to reveal how a reduction in state funding drove patient groups to form partnerships with the private sector. The resulting power imbalance continues to challenge the groups' ability to put patients' interests ahead of those of the industry. Batt's conclusion is unsettling: a once-vibrant movement that encouraged democratic participation in the development of health policy now eerily echoes the demands of the pharmaceutical industry. This thorough account of the shift from grassroots advocacy to Big Pharma partnership defines the struggles and stakes of activism in public health today.\"-- Provided by publisher.
Book
The secret history of the war on cancer
From the National Book Award finalist, author of When Smoke Ran Like Water, a searing, haunting and deeply personal account of the War on Cancer.
eBook
Strategies to decrease inequalities in cancer therapeutics, care and prevention
Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. The development of basic technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the USA‐Cancer Moonshot and the EU‐Mission on Cancer and Europe's Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organized by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research defined as a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention modalities. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and clinical research, as for ensuring state‐of‐the‐art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost‐effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivizing research aimed at prevention and cancer therapeutics/care with an increased focus on patients' needs and cost‐effective healthcare.
Journal Article
Mammography wars : analyzing attention in cultural and medical disputes
Winner of the 2024 Outstanding Book Award, Social Problems Theory Division, Society for the Study of Social Problems Mammography is a routine health screening performed forty million times each year in the United States, yet it remains one of the most deeply contested topics in medicine, with national health care organizations supporting.
eBook
Impact of doctor-shopping behavior on patient survival in lung cancer: findings from a 11-year cohort study using Korean claims data
Background
This population-based cohort study aimed to explore the impact of doctor-shopping behavior (DSB) on the survival of new patients with lung cancer in Korea to make policy suggestions for the efficient use of medical care for cancer patients.
Methods
The cancer cohort data used in this study were obtained from the Korean National Health Insurance Service database, which contains claim records for all cancer patients in Korea between 2009 and 2021. After setting the washout period and exclusion criteria, 280,030 patients were found to be eligible for the analysis. The outcome variables were death within 30 days, 90 days, 1 year, and survival over 5 years after the first diagnosis. DSB, a variable of interest, was defined as the number of visits from the first diagnosis to the first treatment, and was classified into four quartiles. A multiple logistic regression model was used to examine the effects of DSB on the survival of patients with lung cancer.
Results
Compared to patients who visited the doctor less than once (Q1), those with 2–9 visits (Q2, Q3) had a lower likelihood of death within 30 days, 90 days, and 1 year, and a higher probability of survival over 5 years. However, patients with more than 10 visits (Q4) had significantly increased odds of death. Moreover, those with excessive doctor shopping had about a 12% decrease in the likelihood of surviving beyond 5 years compared to those with minimal visits (95% CI: 0.85–0.92). Stratified analysis revealed that, especially when patients who are middle class or higher living in metropolitan cities engage in excessive doctor shopping, the likelihood of death within 1 year increases by 14–18%, and the survival rate over 5 years decreases by 12–18%, compared to those who rarely doctor shopped.
Conclusion
For patients with lung cancer, moderate doctor shopping can positively affect survival, while excessive visits can increase mortality. This effect was more notable among patients with middle or higher incomes and those living in metropolitan cities. These results highlight the need for policies that regulate the use of medical resources, especially among patients with greater access to medical care, to ensure the efficient utilization of medical care for improved health outcomes.
Journal Article
Strategies to reduce the cancer burden and improve access to effective and affordable cancer interventions in Europe
The development of new anticancer treatments, their clinical evaluation and introduction into the healthcare system need improvement. New drugs and cell therapies often come with significant costs for society while only marginally improving patients' survival and health‐related quality‐of‐life. Therefore, bold, innovative clinical trials with critical assessment of the efficacy and cost‐effectiveness of new preventive measures and medical treatments are needed to ensure that patients and society benefit. Drug development programmes controlled by pharma should be complemented with initiatives such as stop studies, dose reduction, combination and repurposing trials. These should be validated in academia‐initiated trials supported by societal funds. Special attention should be devoted to paediatric and rare adult cancers. Comprehensive Cancer Centres (CCCs) covering the entire cancer research continuum, present throughout the EU, are critical for this. More of such centres must be established concomitantly with a robust accreditation methodology to ensure that they meet appropriate quality standards. It is crucial that funding for these initiatives, now temporarily and partially provided by the EU Cancer Mission and Europe's Beating Cancer Plan, is secured for a much longer period. Comprehensive cancer centre (CCCs) and CCCs of Excellence (CCCoE) integration in healthcare. Through outreach to surrounding community hospitals, CCCs enable wider access to top‐clinical cancer treatments and care, thereby facilitating the swift enrolment of patients into data‐rich clinical trials (PI‐initiated trials testing new concepts, drug combination trials and dose reduction trials) and outcomes research (assessing real‐world effectiveness and health economics of new treatments).
Journal Article
Academia and society should join forces to make anti‐cancer treatments more affordable
Discovery research is the starting point for the development of more effective anti‐cancer treatments. It requires an interdisciplinary research environment with first‐class infrastructural support in which curiosity‐driven research can lead to new concepts for treating cancer. Translating such research findings to clinical practice requires complementary skills and infrastructures, including high‐quality clinical facilities, access to patient cohorts and participation of pharma. This complex ecosystem has yielded many new but also “me too” treatment regimens, especially in immuno‐oncology resulting in an extremely high pricing of anti‐cancer agents. The costs of antibodies, vaccines, and cell therapies charged by pharma stand out although the concepts and methodologies have been largely developed in academia, financed from public funds. Comprehensive Cancer Centres (CCCs) covering a coherent stretch of the cancer research continuum are well‐positioned to make these personalized treatments more affordable, but this will require restructuring of the way the translational cancer research continuum is funded. There is an urgent need to reconsider the way we organize drug development and assess their value for cancer patients and their cost‐effectiveness. Networks of comprehensive cancer centers and society at large need to take initiatives to play a more prominent role in the development of new anti‐cancer treatments.
Journal Article
Engaging European society at the forefront of cancer research and care: How discussions at the 5th Gago Conference on European Science policy led to the Heidelberg Manifesto
European cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation.European cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation.
Journal Article
From the creation of the European research area in 2000 to a Mission on cancer in Europe in 2021‐lessons learned and implications
In the year 2000, cancer research in Europe had the potential to make a difference as it had several unique strengths, such as a strong foundation in biomedical science, good patient registries, infrastructures that spanned from biological repositories to bioinformatic hubs as well as thriving Comprehensive Cancer Centers (CCCs) and basic/preclinical cancer research institutions of high international standing. Research, however, was fragmented and lacked coordination. As a result, Europe could not harness its potential for translating basic research discoveries into a clinical setting for the patients' benefit. What was needed was a paradigm shift in cancer research that addressed the translational research continuum. Along these lines, in 2000, European Union (EU) Commissioner Philippe Busquin established the European Research Area (ERA) and in 2002 the European Cancer Research Area (ECRA), and their political approval was a powerful catalyst for the increased involvement of scientists in science policy in the EU. In this report, we briefly describe the actions embraced by the cancer community and cancer organizations in response to Busquin's proposals that led to the creation of the EU Mission on Cancer (MoC) in Horizon 2020 in 2021. This report briefly describes the actions embraced by the cancer community and cancer organizations in reponse to Commissioner Busquin´s proposals in 2000 and 2002 that led to the creation of the EU Mission on Cancer.
Journal Article
Does fragmented cancer care affect survival? Analysis of gastric cancer patients using national insurance claim data
Background
We aimed to investigate the association between fragmented cancer care in the early phase after cancer diagnosis and patient outcomes using national insurance claim data.
Methods
From a nationwide sampled cohort database, we identified National Health Insurance beneficiaries diagnosed with gastric cancer (ICD-10: C16) in South Korea during 2005–2013. We analyzed the results of a multiple logistic regression analysis using the generalized estimated equation model to investigate which patient and institution characteristics affected fragmented cancer care during the first year after diagnosis. Then, survival analysis using the Cox proportional hazard model was conducted to investigate the association between fragmented cancer care and five-year mortality.
Results
Of 2879 gastric cancer patients, 11.9% received fragmented cancer care by changing their most visited medical institution during the first year after diagnosis. We found that patients with fragmented cancer care had a higher risk of five-year mortality (HR: 1.310, 95% CI: 1.023–1.677). This association was evident among patients who only received chemotherapy or radiotherapy (HR: 1.633, 95% CI: 1.005–2.654).
Conclusions
Fragmented cancer care was associated with increased risk of five-year mortality. Additionally, changes in the most visited medical institution occurred more frequently in either patients with severe conditions or patients who mainly visited smaller medical institutions. Further study is warranted to confirm these findings and examine a causal relationship between fragmented cancer care and survival.
Journal Article