Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review

Abstract

Background: Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low-and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care. Aim: To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa. Methods: A scoping review was performed following the method of Arksey and O'Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). Results: A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for fullarticle screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care. Conclusions: Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.

Duration of intervals in the care seeking pathway for lung cancer in Bangladesh: A journey from symptoms triggering consultation to receipt of treatment

“…15.2 ± 24.4 (median 10) days in this study. This is shorter than time periods reported from symptom onset to contact with a medical doctor in other countries, including 71 days in Nepal [44], 94 days in India [45], and 35 days or 49.9 ± 96.9 days in Turkey [16,46], however, these studies did not include informal providers as first contact. In this study, informal healthcare providers were the first choice for seeking healthcare reported by most respondents (60%), hence this duration is shorter than other studies mentioned above.…”

Pilot Study of Feasibility to Reduce Lead Times in Colorectal Cancer Treatment in a Moroccan Cancer Center: A Convergent Mixed Method Study

“…It should be pointed out from the outset that the decision taken by the NIO to carry out specialized consultations on the same day for new patients contributes directly to reducing the overall waiting time, and the time to obtain an appointment with a specialist surgeon is cited as a signi cant phase in the patient pathway [11,[23][24][25]. The study has shown that the action of improving the quality of care at the hospital level could be handled in two ways: bottom-up creative strategies at the hospital level, and a topdown normative strategy from a more centralized level [26].…”

Experimental and Computational Evaluation of Chloranilic Acid as an Universal Chromogenic Reagent for the Development of a Novel 96-Microwell Spectrophotometric Assay for Tyrosine Kinase Inhibitors

“…The majority of health care systems in developed countries are little prepared to deal with this challenge, and many cancer patients globally will not have the privilege of early treatment. In these countries, nearly two-thirds of cancer patients die [ 6 ]. There is evidence that shows that in countries where national health services are well-developed, strategies such as early detection, treatment and survivorship care are improving the survival rates of many types of cancers [ 1 , 6 ].…”