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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 8945

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Dr. Carla Williams

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Guest Editor

Medicine and Public Health and Interim Director, Howard University Cancer Center, Howard University, Washington, DC 20059, USA
Interests: cancer disparities; tobacco cessation and control; community engaged research

Special Issue Information

Dear Colleagues,

Cancer health disparities remain a massive public health challenge.

Cancer burden varies across various populations, with higher incidence and mortality of specific cancer types in some populations compared to others, resulting from varying degree of interactions between genetic/biologic, behavioral, societal, and environmental risk factors.Therefore Achieving cancer health equity via social and therapeutic interventions is required to address the racial gap in cancer incidence, disease aggressiveness, clinical and therapeutic outcome, and overall survival.

We are pleased to invite you to submit your work addressing cancer disparity to gain cancer health equity. For this Special Issue of the International Journal of Environmental Research and Public Health, we invite research papers, reviews, case reports, methodological papers, brief reports, and commentaries on geographic (e.g., neighborhood, region, rurality) diparities in the cancer control continuum (including prevention, detection, treatment, and survivorship). Epidemiologic and intervention studies on etiology, behaviors, incidence, mortality, quality of life, policy, and other factors relevant to cancer are welcome. International submissions encouraged.

Dr. Carla Williams
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

health disparities
cancer disparities
social determinants
health policy
health equity and social justice
health care research
cancer treatment

Published Papers (6 papers)

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Research

14 pages, 248 KiB

Open AccessArticle

Perception of Women’s Knowledge of and Attitudes towards Cervical Cancer and Papanicolaou Smear Screenings: A Qualitative Study in South Africa

by Zintle Gwavu, Daphne Murray and Uchenna Benedine Okafor

Healthcare 2023, 11(14), 2089; https://doi.org/10.3390/healthcare11142089 - 21 Jul 2023

Cited by 2 | Viewed by 1632

Abstract

Background: Cervical cancer is the most common form of cancer worldwide. Consequently, it is crucial that women are encouraged to undergo interventions early via Papanicolaou (Pap) smear screenings to improve their health. In light of this, this study explored the knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings among women in the Caleb Motshabi district, South Africa. Four focus group discussions were carried out among 19 women. The interviews/discussion were audio-recorded and transcribed verbatim and then analysed thematically. In this regard, seven main themes emerged that provided insight into the perceptions of the participants regarding their knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings. While the majority of participants were aware of cervical cancer and Pap smears, they lacked more specific knowledge of what this cancer is or its related causes. Although some participants had had a Pap smear done, they neither knew how the procedure was done nor the reasons for it. In addition, most mentioned receiving information about this procedure from their peers rather than healthcare workers. Notably, those with previous experience indicated that they had regular screenings. Furthermore, they better understood exactly how it is done. The findings emphasised women’s limited knowledge of cervical cancer and Pap smears. It further highlighted the need for sustainable education programmes and mobile clinics to encourage an awareness of and accessibility to this particular type of screening within South African communities. Therefore, intervention strategies that make people aware of this specific cancer and encourage the uptake of Papanicolaou (Pap) smear screenings are crucial, as is the continued advocacy for sustained educational programmes and accessible healthcare services. Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

16 pages, 2363 KiB

Open AccessArticle

Epithelial Ovarian Cancer—Varied Treatment Results

by Sonja Millert-Kalińska, Marcin Przybylski, Dominik Pruski, Małgorzata Stawicka-Niełacna and Radosław Mądry

Healthcare 2023, 11(14), 2043; https://doi.org/10.3390/healthcare11142043 - 17 Jul 2023

Cited by 1 | Viewed by 813

Abstract

Ovarian cancer (OC) is the eighth most common cancer worldwide and is usually diagnosed in advanced stages. Despite many available data, no treatment results have been reviewed in Poland. This study enrolled 289 first-time patients treated between 2018 and 2021 by the Department of Oncology of the Poznań University of Medical Sciences (SKPP). The relationships among starting treatment in our centre, the type of first intervention, and the final decision were significant (p < 0.001). Patients in the SKPP group were more likely to primarily have a laparoscopy and less likely to have an exploratory laparotomy. Neoadjuvant chemotherapy (NACT) after a laparotomy was less often a final decision among SKPP patients (9% vs. 22%), in contrary to NACT after a laparoscopy (23% vs. 4%). Factors affecting the shortening of progression-free survival (PFS) were an advanced stage of the disease, a histopathological diagnosis, the type of cytoreduction, and the final decision. Significance according to the final decision was revealed for PDS vs. NACT after a laparotomy (p < 0.001) and for PDS vs. NACT after a laparoscopy (p = 0.011). Our study supports the benefits of treating ovarian cancer in an oncology centre with a high patient throughput. Further observations might also answer the question about overall survival (OS). Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

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13 pages, 1366 KiB

Open AccessArticle

A Retrospective Analysis Comparing VATS Cost Discrepancies and Outcomes in Primary Lung Cancer vs. Second Primary Lung Cancer Patients

by Bogdan Cosmin Tanase, Alin Ionut Burlacu, Claudiu Eduard Nistor, Teodor Horvat, Cristian Oancea, Monica Marc, Emanuela Tudorache, Tudor Mateescu and Diana Manolescu

Healthcare 2023, 11(12), 1745; https://doi.org/10.3390/healthcare11121745 - 14 Jun 2023

Viewed by 781

Abstract

This study aimed to compare the outcomes and cost differences between primary lung cancer (PLC) and second primary lung cancer (SPLC) patients who underwent video-assisted thoracoscopic surgery (VATS). This was a retrospective analysis of 124 patients with lung cancer stages I, II, and III who underwent VATS between January 2018 and January 2023. The patients were divided into two groups based on their cancer status that was matched by age and gender: the PLC group (n = 62) and the SPLC group (n = 62). The results showed that there was no significant difference in the clinical characteristics between the 2 groups, except for the Charlson Comorbidity Index (CCI), with a score above 3 in 62.9% of PLC patients and 80.6% among SPLC patients (p = 0.028). Regarding the surgical outcomes, the operative time for the VATS intervention was significantly higher in the SPLC group, with a median of 300 min, compared with 260 min in the PLC group (p = 0.001), varying by the cancer staging as well. The average duration of hospitalization was significantly longer before and after surgery among patients with SPLC (6.1 days after surgery), compared with 4.2 days after surgery in the PLC group (0.006). Regarding the cost analysis, the total hospitalization cost was significantly higher in the SPLC group (15,400 RON vs. 12,800 RON; p = 0.007). Lastly, there was a significant difference in the survival probability between the two patient groups (log-rank p-value = 0.038). The 2-year survival was 41.9% among PLC patients and only 24.2% among those with SPLC. At the 5-year follow-up, there were only 1.6% survivors in the SPLC group, compared with 11.3% in the PLC group (p-value = 0.028). In conclusion, this study found that VATS is a safe and effective surgical approach for both PLC and SPLC patients. However, SPLC patients have a higher VATS operating time and require more healthcare resources than PLC patients, resulting in higher hospitalization costs. These findings suggest that careful pre-operative evaluation and individualized surgical planning are necessary to optimize the outcomes and cost-effectiveness of VATS for lung cancer patients. Nevertheless, the 5-year survival remains very low and concerning. Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

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10 pages, 253 KiB

Open AccessArticle

Emotional Problems, Quality of Life and Symptom Burden in Patients with Chordoma

by Youtu Wu, Chuzhong Li, Huifang Zhang, Guoqin Wang, Linkai Jing, Guo Yi, Xuejun Yang, Songbai Gui, Hua Gao, Yazhuo Zhang, Guihuai Wang and Jiwei Bai

Healthcare 2023, 11(8), 1135; https://doi.org/10.3390/healthcare11081135 - 14 Apr 2023

Viewed by 1545

Abstract

Chordomas are very rare malignant bone tumors. Following surgery, their effects on neurological, physical, psychological, social, and emotional functioning are substantial and can have a major impact on a patients’ quality of life (QOL). In this survey, we aimed to characterize the postoperation health-related QOL and emotional problem in patients with chordoma using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) and Hamilton Depression Rating Scale (HAMD). The cohort included 100 patients who underwent resection surgery between 2014 and 2020. Being single or divorced, living in a rural area, receiving a diagnosis of sacrococcygeal chordoma, Karnofsky performance status (KPS) ≤ 70, and weight loss were associated with increased likelihood of depression (p < 0.05). Patients who were single or divorced, with KPS ≤ 70, and experiencing weight loss had a higher likelihood of a worse QOL (p < 0.05). The uni- and multivariate logistic regression analyses indicated that the KPS level (p = 0.000) and postoperative radiation therapy (p = 0.009) were related to depression; marital status (p = 0.029), KPS level (p = 0.006), and tumor location (p = 0.033) were related to worse QOL. Certain characteristics placed patients with chordoma at increased risk of emotional problems, which are associated with a lowered QOL and a higher symptom burden. Further knowledge regarding emotional problems is key to improving the QOL for patients with chordoma. Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

8 pages, 379 KiB

Open AccessArticle

Impact of Disability Status on Mortality in Patients with Gastric Cancer: A Nationwide Study Focusing on Regional Disparities

by Woo-Ri Lee, Kyu-Tae Han, Mingee Choi, Seojin Park and Woorim Kim

Healthcare 2023, 11(5), 641; https://doi.org/10.3390/healthcare11050641 - 21 Feb 2023

Cited by 1 | Viewed by 1013

Abstract

Background: Disparities in mortality according to disability status require investment, as individuals with disabilities form the largest subset of the vulnerable population. This study aimed to investigate the association between mortality and disability status in patients with gastric cancer as well as how regional disparities modify this relationship. Methods: Data were obtained from the National Health Insurance claims database in South Korea for the period of 2006–2019. The outcome measures were all-cause 1-year, 5-year, and overall mortality. The main variable of interest was disability status, categorized into “no disability”, “mild disability”, and “severe disability”. A survival analysis based on the Cox proportional hazards model was conducted to analyze the association between mortality and disability status. Subgroup analysis was conducted according to region. Results: Of the 200,566 study participants, 19,297 (9.6%) had mild disabilities, and 3243 (1.6%) had severe disabilities. Patients with mild disabilities had higher 5- and overall mortality risks, and those with severe disabilities had higher 1-year, 5-year, and overall mortality risks than those without disabilities. These tendencies were generally maintained regardless of the region, but the magnitude of the differences in the mortality rates according to disability status was higher in the group residing in non-capital regions than in the group living in the capital city. Conclusion: Disability status was associated with all-cause mortality in patients with gastric cancer. The degree of the differences in mortality rates among those with “no disability”, “mild disability”, and “severe disability” was augmented in the group residing in non-capital regions. Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

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11 pages, 2887 KiB

Open AccessArticle

Patients’ Perspectives of Interprofessional Collaboration in Breast Cancer Unit

by Dea Anita Ariani Kurniasih, Elsa Pudji Setiawati, Ivan Surya Pradipta and Anas Subarnas

Healthcare 2023, 11(3), 332; https://doi.org/10.3390/healthcare11030332 - 23 Jan 2023

Cited by 2 | Viewed by 2725

Abstract

Interprofessional teamwork provides significant benefits for patients. However, qualitative research on interprofessional collaboration in the breast cancer unit is uncommon. Therefore, a qualitative study was conducted to assess the perceptions of outpatient breast cancer patients regarding interprofessional collaboration in the breast care unit of an Indonesian referral center hospital. The teamwork involved in the interprofessional collaboration included breast cancer specialists, pharmacists, and nurses. In this study, in-depth interviews were performed with nine breast cancer outpatients. All interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. The findings were divided into two categories to gather breast cancer patients’ viewpoints on interprofessional collaboration: (1) obstacle components to interprofessional collaboration: incompleteness of health personnel, no justification from health personnel, no knowledge of patients about health professionals, no involvement of patients in the therapy decision making; (2) enabling elements: patient-oriented, patient expectations, collaboration among healthcare personnel, patient participation in interprofessional collaboration, health personnel responsibilities, comprehensive hospital services. Respondents assumed interprofessional collaboration positively. However, several obstacles must be overcome to implement interprofessional collaboration in a breast care setting effectively. The research findings can be utilized to establish interprofessional collaborations aimed at improving quality healthcare in breast cancer units. Full article

(This article belongs to the Special Issue Cancer Healthcare Disparities)

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