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Health Equity Report Card (健康公平性報告表) 試驗項目有助消弭世界癌症日強調的照護差距
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National Comprehensive Cancer Network

Feb 04, 2023, 08:07 ET

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一項正在進行的試驗項目旨在評估實施健康公平性報告表的可行性,使其作為改善癌症護理品質和公平性的工具,並繼續透過國家綜合癌症網絡 (NCCN)、美國癌症協會癌症行動網絡 (ACS CAN) 和國家少數族裔品質論壇 (NMQF) 來加強癌症公平性方面的合作。

賓夕凡尼亞州普利茅斯米庭2023年2月4日 /美通社/ -- 國家綜合癌症網絡® (NCCN®) 是由美國主要的癌症中心組成的非牟利聯盟,它透過推出嶄新的 Health Equity Report Card (健康公平性報告表,簡稱 HERC) 試驗計劃,在世界癌症日加入呼籲消弭護理差距。世界癌症日是國際抗癌聯盟 (UICC) 於每年 2 月 4 日舉辦的全球意識日。這項全球訊息承認,許多生命由於癌症結果的懸殊而喪失。NCCN 於世界各地致力改善和促進優質、有效、公平和可獲得的癌症照護,以便所有病患都能活得更好。今天的公佈進一步說明了 HERC 試驗計劃的由來以及它將實現的目標。

結構性和人際種族主義的影響是美國癌症結果懸殊的主要原因之一。根據美國癌症協會的 2023 年癌症事實和數據,各種族和族裔在癌症負擔上的懸殊,很大程度上反映了社會經濟地位和獲得優質醫療照護長期的不平等,這可歸因於所有有色人種在美國經歷的歷史和持續的結構性種族主義。

為求解決這些問題,NCCN、ACS CAN 和 NMQF 於 2020 年推出了Elevating Cancer Equity (提高癌症公平性) 計劃,其中包括由維吉尼亞聯邦大學 Massey 癌症中心總監 Robert A. Winn 醫學博士,和患者倡導基金會健康公平性和社區參與執行副總裁 Shonta Chambers (社會工作碩士) 主持的工作小組。該小組在 2021 年初推出了 HERC,建議作出可採取的實踐改變。一旦實施,將有助提供者和醫療保健組織識別和解決提供護理服務中的歧視行為和偏見、應對關乎健康的社會決定因素,並克服達至最佳護理的系統性障礙。

來自 HERC 的 17 項可採取的實踐已被調整為一項實施計劃,包括具體指標、證據來源和評分方法,所有各項都經由腫瘤學管理者和醫療保健提供者審查。在多階段試驗的首階段中,五個主要的學術癌症中心正在評估實施 HERC 作為一項可以有意義並可行地衡量及報告公平護理實踐的工具之可行性。在試驗階段獲得的回饋意見,將被合併於實施中從而確保在各照護環境和地域的適用性。

NCCN 行政總裁 Robert W. Carlson 醫學博士表示:「我們希望健康公平性報告表能夠成為讓醫療保健組織致力改善其實踐的藍圖、為病患提供透明度的工具,以及付款人和認證實體可使用的評估工具。各種族和族裔之間癌症結果不平等的因素繁多,包括獲得全面承保範圍的差別、護理提供方面的偏見和歧視,以及關乎健康的社會決定因素,例如社區和建設環境、獲得經濟和教育的機會,以及由於歷史和持續的結構性歧視而導致的糧食不安全感。這個問責工具不僅是一項清單練習;我們希望它能帶來干預措施,從而邁向有意義、可持續的系統變化。」

ACS CAN 總裁 Lisa Lacasse 表示:「所有確診患有癌症的人都應獲得所能提供的最佳護理,無論其收入、種族、族裔、性別認同、殘疾狀況、性取向、年齡或地域為何。確保癌症照護的公平性對於縮減癌症懸殊和消除我們所知的癌症,對每個人來說都至關重要。健康公平性報告表提供一個有助實現這目標的切實方法。」

國家 少數族裔品質論壇總裁兼行政總裁 Gary Puckrein 表示:「儘管近幾十年來癌症的檢測和治療取得了顯著進展,但少數社群仍然承受著沉重的癌症負擔。「癌症護理的不公平性是未能顧及黑人、棕色、黃色、紅色人種和貧窮人群生活的結果。如果我們要消弭癌症護理的系統性差距,我們必須重新設想我們要如何提供護理和重新調整系統,以降低患者的風險。此工具是邁向正確方向的一步,以識別促使變化所需的系統變化。」

學術癌症中心的 HERC 試驗計劃獲得 AbbVie Inc.、2seventy bio、Genentech, Inc.、Lilly 和 Sanofi Genzyme 的捐助支援。於社區醫院進行的第二個試驗計劃也處於早期階段,獲得 GlaxoSmithKline LLC、Lilly、Merck Foundation 和 Pfizer Inc. 的支援。一篇具有更多關於該計劃資訊的同行評審文章即將在《全國綜合癌症網絡期刊》(JNCCN) 上發表。

除了在美國的種族和族裔外,有研究顯示收入、教育、地域位置,以及基於性別、性取向、年齡、殘疾和生活方式的歧視,都是所有可能對癌症照護和結果構成負面影響的因素。低資源和中等資源國家的癌症負擔尤其沉重,目前佔全球所有癌症死亡人數約 75%,預計將繼續增長1。

NCCN 參與多項全球舉措以解決這些懸殊,包括在臨床和病患指南中採用共融語言,以及在下述各地的持續合作:

  • 非洲撒哈拉以南 
  • 拉丁美洲和加勒比地區 
  • 東歐 
  • 中東和北非 (MENA) 
  • 以及全球

如欲了解更多有助消弭全球照護差距的免費資源,可瀏覽 NCCN.org/global,並在 NCCN.org/wcd 閱覽健康公平性報告表的 17 項行動。

關於國家綜合癌症網絡 國家綜合癌症網絡® (NCCN®) 是由主要的癌症中心組成的非牟利聯盟,致力於患者護理、研究和教育。NCCN 致力改善和促進優質、有效、公平和可獲得的癌症護理,以便患者可以活得更好。《NCCN 腫瘤學臨床實踐指南》 (NCCN 指南®) 為癌症治療、預防和支援服務提供透明、基於證據的專家共識建議;它們是癌症管理方面公認的臨床方向和政策標準,並是任何醫學領域可供採用的最仔細及最頻繁更新的臨床實踐指南。《NCCN 病患指南》®透過 NCCN 基金會的支援來提供專業的癌症治療資訊,旨在向病患和照護者提供資訊和賦能。NCCN 亦進動腫瘤學的持續教育、全球倡議、政策以及研究合作和出版。如欲了解更多資訊,請瀏覽 NCCN.org。

關於 ACS CAN
美國癌症協會癌症行動網絡 (ACS CAN) 促使癌症成為各級政府政策制定者的首要任務。ACS 與全國各地的義工合作,讓他們的心聲獲得聆聽,以確保我們的城市、州和國家採用基於證據的公共政策,以改善癌症患者及其家人的生活。我們相信每個人都應該獲得公平和公正的機會來預防、檢測和治療癌症並生存下去。自 2001 年以來,作為美國癌症協會的非牟利、無黨派倡導聯盟,ACS CAN 已成功倡導數十億美元的癌症研究資金,令更多人獲得優質實惠的醫療保健,以及推進行之有效的煙草控制措施。我們與義工並肩作戰,努力改變公共政策,以消除我們所知的癌症。請瀏覽 www.fightcancer.org 加入這項對抗。

關於國家少數族裔品質論壇 國家少數族裔品質論壇 (NMQF) 是一個 501(c)(3) 非牟利研究和倡導組織,總部位於華盛頓特區。NMQF 的使命是透過確保為所有人提供最佳照護來降低病患的風險。NMQF 的願景是,美國的健康服務研究、提供和融資系統的運作原則,不僅在於降低可防預的患者發病率和死亡率風險,並同時提高生活品質。NMQF 領導 Cancer Stage Shifting Initiative (癌症階段轉移計劃) 與白宮的癌症 Moonshot 計劃脗合,令我們從癌症的後期診斷提前至早期診斷和治療,改善癌症護理並為所有人減低癌症死亡率,尤其著重於公平性和代表性不足的人群。如欲了解更多資訊,請瀏覽 https://www.nmqf.org/。

傳媒聯絡人:
Rachel Darwin
,NCCN
267-622-6624
[email protected] 

Trista Hargrove,ACS CAN
202-998-2262
[email protected]

1 Prager GW, Braga S, Bystricky B, et al. Global cancer control: responding to the growing burden, rising costs and inequalities in access. 2018;3(2):e000285.

National Comprehensive Cancer Network

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