Informing Policy to Close the Cancer Care Gap – Research Highlights from PLOS ONE

To celebrate World Cancer Day 2024, the final year focused on the theme “Close the Care Gap”, we are highlighting some of our favorite articles related to this years theme, including building awareness and informing future policies.

Reduced availability, affordability, and access to healthcare services, including screening, contribute to gaps in cancer care. These disparities are more acutely obvious in low- and middle-income countries, and can also be influenced by social factors such as socioeconomic status, race, gender, and disability, among others. 2024 marks the final year of the 3-year World Cancer Day campaign theme focusing on closing the cancer care gap, by inspiring change through promoting the application of research findings to influence future policies, and working to reduce care disparities and provide equitable access to cancer screening and treatments for all.

Research Highlights

The following PLOS ONE articles describe research addressing this theme, by suggesting new tools to provide clearer guidance for pediatric cancer diagnosis and treatments, and investigating how socioeconomic status can influence preventative and screening behaviors.

Botta and colleagues study protocol for the application of the international staging guidelines for pediatric tumors focuses on common solid tumors to increase the detail of data in population-based cancer registries. The study aims to increase data reliability for comparisons of staging at diagnosis and survival rates, and to improve understanding of differences within and between countries for each of these cancers, which may reduce outcome disparities by facilitating sharing of the best treatments for these cancers based on diagnostic staging.

COVID-19 had significant impact on cancer diagnosis and care accessibility: however, few papers have investigated the influence of the pandemic on cancer prevention. Elsaid and colleagues demonstrated changes in cancer prevention behaviors which resulted from COVID-related restrictions, by comparing pre- and post-COVID data on physical activity, dietary choices, alcohol and tobacco consumption. They found significant changes in behavior, with increased impact on lower socioeconomic communities.

Access to cancer screening can be challenging for rural and remote populations, such as Brazilian indigenous women. Using cytological results from the Women’s Hospital laboratory database at the University of Campinas, Novias and colleagues found a higher prevalence of both cytological low- and high-grade squamous intraepithelial lesions in indigenous women compared with the general population. The protective screening effect in reducing high-grade squamous intraepithelial lesions was not seen indigenous women, who may also lack access to protective HPV vaccinations. These results have implications for future strategies to guide public policies around cervical cancer screening in this population.

Vanaclocha-Espi and colleagues developed an individual socioeconomic status index for use in the analysis of inequalities in colorectal cancer screening programs in Spain. Validation of the index found that residents of lower socioeconomic status were less likely to engage in colorectal cancer screening compared with those with higher socioeconomic status.

Understanding cancer patient outcomes can inform policies related to screening and treatment decisions. Globus and colleagues utilized the SEER database to characterize early mortality in a range of metastatic solid tumors. They determined the most common cancers resulting in early death, as well as associated factors such as primary site metastases, increased age, and lower income. With limited improvement over the past decade, further research is required to better identify patients at risk for early mortality, who might benefit from faster diagnostic approaches.

In addition to the articles highlighted above, take a look at our related article collection on Cancer and Social Inequity, which showcases recently published articles in PLOS ONE exploring the issues in reaching equitable outcomes in cancer-related healthcare, especially within the underserved communities.

Coming Soon: A new article collection Early Detection, Screening and Diagnosis of Cancer, which includes research on promising new approaches to tackle diagnostic challenges, including disparities in screening uptake.

References

Botta L, Gatta G, Didonè F, Lopez Cortes A, Pritchard-Jones K, the BENCHISTA Project Working Group (2022) International benchmarking of childhood cancer survival by stage at diagnosis: The BENCHISTA project protocol. PLoS ONE 17(11): e0276997.

Elsaid MI, Zhang X, Schuster ALR, Plascak JJ, DeGraffinreid C, Paskett ED (2023) The impact of socioeconomic status on changes in cancer prevention behavior during the COVID-19 pandemic. PLoS ONE 18(6): e0287730.

Novais IR, Coelho CO, Machado HC, Surita F, Zeferino LC, Vale DB (2023) Cervical cancer screening in Brazilian Amazon Indigenous women: Towards the intensification of public policies for prevention. PLoS ONE 18(12): e0294956.

Vanaclocha-Espí M, Pinto-Carbó M, Martín-Pozuelo J, Romeo-Cervera P, Peiró-Pérez R, Barona C, et al. (2022) Construction of an individual socioeconomic status index for analysing inequalities in colorectal cancer screening. PLoS ONE 17(12): e0278275.

Globus O, Sagie S, Lavine N, Barchana DI, Urban D (2023) Early death after a diagnosis of metastatic solid cancer–raising awareness and identifying risk factors from the SEER database. PLoS ONE 18(9): e0281561.