scholarly journals Building a Comprehensive Cancer Center: Overall Structure

2021 ◽  
pp. 3-13
Author(s):  
Dolores Grosso ◽  
Mahmoud Aljurf ◽  
Usama Gergis

AbstractAccording to the World Health Organization (WHO), cancer is the second leading cause of death globally, accounting for approximately 9.6 million deaths [1]. The WHO recommends that each nation has a national cancer control program (NCCP) to reduce the incidence of cancer and deaths related to cancer, as well as to improve the quality of life of cancer patients [2]. Comprehensive cancer centers form the backbone of a NCCP and are charged with developing innovative approaches to cancer prevention, diagnosis, and treatment [3]. This is accomplished through basic and clinical research, the provision of patient care, the training of new clinicians and scientists, and community outreach and education. Most comprehensive cancer centers are affiliated with university medical centers, but their cancer care initiatives may involve partnering outside the institution with other comprehensive cancer centers, community leaders, or members of industry [3]. When affiliated with a university medical center, cancer center executives must work in concert with their counterparts at the hospital, patient practice, medical school, and allied health science leaders resulting in an overlapping, often complicated reporting structure. Comprehensive cancer centers and the departments in the center receive funding for their services from various sources, including national and local grants, institutional funds, private donations, and industry [4].

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 240s-240s
Author(s):  
M. Kuriakose ◽  
P. Sebastian ◽  
S. Balasubramanian ◽  
R. Sadanandan

Background and context: Traditional method of managing cancer through establishing large comprehensive cancer centers are ineffective in developing country setting that has poorly developed primary health care facilities. These larger cancer centers become victims of their success and attract increasing number of patients from distant places, overstretching the resources and increasing out-of-pocket expenses for the patients. Increasing the number of cancer centers also is not effective as each unit by itself will not have the critical mass of expertise to offer comprehensive cancer care. In addition, for sustainability and improved resource utilization, the cancer care needs to be integrated with the existing health care system. The state with a population ∼ 33.3 million has 19 cancer treatment facilities distributed throughout the coastal districts. The cancer incidence rate of the state is 128 per 100,000, which is the fourth highest in the country. Aim: To develop a model for distributed, decentralized digitally connected cancer control program for the state of Kerala, India. Strategy/Tactics: A model for distributed, decentralized digitally connected cancer care that offers resource stratified cancer care and integrate with the existing health care. Program/Policy process: The distributed cancer care network for the state that will be digitally connected using a recently introduced e-health program to interconnect the cancer care as well as to integrate with the existing healthcare network. The cancer centers will be stratified in 4 levels. Level 1 would be 3 apex cancer centers with most advanced infrastructure and serves as quaternary centers and coordinate cancer care in 3 zones. The Level 2 cancer centers established at medical colleges and cancer centers in major private medical hospitals offer comprehensive cancer care in a geographic area and serve as tertiary cancer referral centers. Level 3 centers are located in the district and Taluk hospitals that offers primary cancer care for common cancers including palliative daycare chemotherapy. Level 4 units are established as part of the national health mission in primary and family health centers which provide the important task of cancer surveillance and improving cancer literacy for the public with peoples participation. Outcomes: The expected outcomes are downstaging of cancer, developing a resource-stratified referral pathway that minimize treatment delay, provide cancer care within 90 minutes of travel and lowering out-of-pocket expenses. What was learned: Planning of the program involved participation of major stakeholders of cancer and health care of the state as well as NGO.


2021 ◽  
Vol 2 (2) ◽  
pp. 018-027
Author(s):  
Surabhi Gupta ◽  
Bhupendra Singh Chahar ◽  
Kumari Puja

Background-The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer causing behaviors, particularly smoking in economically developing countries and life style changes. India exhibits heterogeneity in cancer. Since two decade changes in the pattern of cancer has been observed in various studies. So this retrospective study was done to observe the changing pattern in female cancer in our institution during last 10 years. Aims and object-To observe the changes in female malignancies during last 10 years in terms of age shifting and site of presentation. Result/observation-Ca cervix is on decreasing trend while ca breast is on increasing pattern.Ca gallbladder, ca esophagus, colorectal cancer and ca ovary are on gradually increasing trend while hematological malignancy is showing a sharp rise in trend. Conclusion- Evidence-based policy decision on steps for cancer prevention and cancer control should be formulated. More emphasis should be given on the cancer which are showing an increasing trend so that proper and effective screening and cancer control program can be implicated.


1981 ◽  
Vol 2 (1) ◽  
pp. 35-49
Author(s):  
Thomas W. Elwood ◽  
T. Phillip Waalkes ◽  
William P. Vaughan

The Johns Hopkins Oncology Center, one of the first of the nation's twenty-one Comprehensive Cancer Centers, established a cancer control program to mobilize resources to improve patient care and prevent the occurrence of neoplastic diseases. Initial efforts were based on the results of a series of investigations conducted in four communities. Findings from these studies were then converted into a series of programmatic interventions. The strategy included integrated approaches to creating a community education program within the overall effort.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 244s-244s
Author(s):  
N. Abdelmutti ◽  
A. Chudak ◽  
M. Merali ◽  
T. Sullivan ◽  
M. Escaf ◽  
...  

Background and context: Comprehensive cancer centers or programs form a nucleus of cancer care delivery. Although there are frameworks for population cancer control, no similar published framework exists for cancer centers. Aim: We sought to develop a framework for designing and implementing a comprehensive cancer center or program within the context of a population-based model of cancer control that spans diagnosis, treatment, supportive care, and palliative care as well as integration with primary care and the community. Strategy/Tactics: The framework was constructed with the patient at the center and provides a system-level perspective as well as a granular view of the fundamental resources and structures needed to build and maintain individual cancer centers and programs. Due to its breadth, we focused the framework on essential information while linking to a wide range of vetted publications that detail additional standards, guidelines and best practices. Program/Policy process: “Cancerpedia” emerged as a cohesive framework for the delivery of high-quality cancer care within and beyond the cancer center. It provides an overview of the cancer control and care delivery framework, describes cancer care services (e.g., radiotherapy, chemotherapy, palliative care) and details infrastructure and core services (e.g., physical facilities, human resources). In addition to these services, the framework presents guidelines for governance that ensure oversight and quality, describes the critical need for integrating education and research and presents the best practices for engaging in philanthropy. Cancerpedia also outlines the role of the comprehensive cancer center in integration with the community and influencing policy and regulation. Over 30 chapters provide a detailed description of each element and include a description of the service or function, resources requirements such as people, equipment and facilities, management structures, quality performance guidelines and future trends in innovation. Outcomes: To our knowledge, no comparable published framework exists as a reference for developing comprehensive cancer centers. Cancerpedia was designed to serve as a global public good and is adaptable and applicable to diverse contexts and healthcare environments. It is relevant to high-, middle- and low-income countries alike and provides a reference point from which to structure a plan for growth. What was learned: While it is important to describe the various elements required for cancer care delivery, it is critical to consider and address the integration and interdependencies of these various elements. Future opportunities for learning include seeking input from a global audience to gauge the utility and applicability of Cancerperdia to local contexts.


2019 ◽  
pp. 1-8
Author(s):  
Gregory C. Knapp ◽  
Gavin Tansley ◽  
Olalekan Olasehinde ◽  
Olusegun I. Alatise ◽  
Funmilola Wuraola ◽  
...  

PURPOSE To address the increasing burden of cancer in Nigeria, the National Cancer Control Plan outlines the development of 8 public comprehensive cancer centers. We map population-level geospatial access to these eight centers and explore equity of access and the impact of future development. METHODS Geospatial methods were used to estimate population-level travel times to the 8 cancer centers. A cost distance model was built using open source road infrastructure data with verified speed limits. Geolocated population estimates were amalgamated with this model to calculate travel times to cancer centers at a national and regional level for both the entire population and the population living on < US$2 per day. RESULTS Overall, 68.9% of Nigerians have access to a comprehensive cancer center at 4 hours of continuous vehicular travel. However, there is significant variability in access between geopolitical zones ( P < .001). The North East has the lowest access at 4 hours (31.4%) and the highest mean travel times (268 minutes); this is significantly lower than the proportion with 4-hour access in the South East (31.4% v 85.0%, respectively; P < .001). The addition of a second comprehensive cancer center in the North East, in either Bauchi or Gombe, would significantly improve access to this underserved region. CONCLUSION The Federal Ministry of Health endorses investment in 8 public comprehensive cancer centers. Strengthening these centers will allow the majority of Nigerians to access the full complement of multidisciplinary care within a reasonable time frame. However, geospatial access remains inequitable, and the impact on outcomes is unclear. This must be considered as the cancer control system matures and expands.


2021 ◽  
pp. 100281
Author(s):  
Dorothy Lombe ◽  
Susan Msadabwe ◽  
Mbaita Maka ◽  
Memory Samboko ◽  
Prudence Haimbe ◽  
...  

Cancer ◽  
2021 ◽  
Author(s):  
Sarah D. Tait ◽  
Yi Ren ◽  
Cushanta C. Horton ◽  
Sachiko M. Oshima ◽  
Samantha M. Thomas ◽  
...  

PEDIATRICS ◽  
1967 ◽  
Vol 40 (3) ◽  
pp. 527-528
Author(s):  
Charles J. A. Schulte

ON JANUARY 1, 1967, the Cancer Control Program will become part of the National Center for Chronic Disease Control within the Public Health Service's new Bureau of Disease Prevention and Environmental Control. Our primary mission is to stimulate and encourage the application of currently available techniques of cancer prevention, cancer detection, and cancer control to the community at the grass roots level. If this will be the case after the reorganization remains to be seen. Figure 1 shows the new organization of the Public Health Service. By way of illustration, I think it would be well to briefly outline a few of our activities. An area of heavy emphasis has been the use of the Papanicolaou smears for cervical cancer control. These programs have been responsible for developing certified cytotechnology training schools, supporting and training large numbers of cytotechnicians. In addition, we are supporting some 90 hospital-based cervical cancer screening projects across the country. A program to encourage the general practitioner to screen his private patients in the office is jointly sponsored by the American Academy of General Practice and the Cancer Control Program. The very grave problem in the United States of smoking and carcinoma of the lung is the major responsibility of tile National Clearinghouse for Smoking and Health, a part of the Division of Chronic Diseases which developed out of the Cancer Control Program. We are engaged in a number of developmental projects, such as the flexible fiber optic proctosigmoidoscope. We hope to be able to produce a proctosigmoidoscope that will reach the splenic flexure.


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