Closing the global cancer divide- performance of breast cancer care services in a middle income developing country

Gerard C C Lim, Emran N. Aina, Soon K. Cheah, Fuad Ismail, Gwo F. Ho, Lye M. Tho, Cheng H. Yip, Nur A. Taib, Kwang J. Chong, Jayendran Dharmaratnam, Matin M. Abdullah, Ahmad K. Mohamed, Kean F. Ho, Kananathan Ratnavelu, Chiao M. Lim, Kin W. Leong, Ibrahim A. Wahid, Teck O. Lim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.Methods: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.Results: Seven hundred and fifty seven patients were included in the study; they represent about 20% of incident BC in Malaysia. Performance results were mixed. Late presentation was 40%. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80% of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19% of eligible patients.Conclusions: These performance results are probably acceptable for a middle income country though far below the 95% or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.

Original languageEnglish
Article number212
JournalBMC Cancer
Volume14
Issue number1
DOIs
Publication statusPublished - 20 Mar 2014
Externally publishedYes

Fingerprint

Developing Countries
Breast Neoplasms
Neoplasms
Malaysia
Breast
Therapeutics
Accreditation
Developed Countries
Observational Studies
Cause of Death
Cohort Studies
Guidelines
Radiation
Costs and Cost Analysis
Population
Trastuzumab

Keywords

  • Breast cancer
  • Cancer burden
  • Developing country
  • Health policy
  • Health services research
  • Health system research
  • Healthcare quality
  • Performance measurement

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Closing the global cancer divide- performance of breast cancer care services in a middle income developing country. / Lim, Gerard C C; Aina, Emran N.; Cheah, Soon K.; Ismail, Fuad; Ho, Gwo F.; Tho, Lye M.; Yip, Cheng H.; Taib, Nur A.; Chong, Kwang J.; Dharmaratnam, Jayendran; Abdullah, Matin M.; Mohamed, Ahmad K.; Ho, Kean F.; Ratnavelu, Kananathan; Lim, Chiao M.; Leong, Kin W.; Wahid, Ibrahim A.; Lim, Teck O.

In: BMC Cancer, Vol. 14, No. 1, 212, 20.03.2014.

Research output: Contribution to journalArticle

Lim, GCC, Aina, EN, Cheah, SK, Ismail, F, Ho, GF, Tho, LM, Yip, CH, Taib, NA, Chong, KJ, Dharmaratnam, J, Abdullah, MM, Mohamed, AK, Ho, KF, Ratnavelu, K, Lim, CM, Leong, KW, Wahid, IA & Lim, TO 2014, 'Closing the global cancer divide- performance of breast cancer care services in a middle income developing country', BMC Cancer, vol. 14, no. 1, 212. https://doi.org/10.1186/1471-2407-14-212
Lim, Gerard C C ; Aina, Emran N. ; Cheah, Soon K. ; Ismail, Fuad ; Ho, Gwo F. ; Tho, Lye M. ; Yip, Cheng H. ; Taib, Nur A. ; Chong, Kwang J. ; Dharmaratnam, Jayendran ; Abdullah, Matin M. ; Mohamed, Ahmad K. ; Ho, Kean F. ; Ratnavelu, Kananathan ; Lim, Chiao M. ; Leong, Kin W. ; Wahid, Ibrahim A. ; Lim, Teck O. / Closing the global cancer divide- performance of breast cancer care services in a middle income developing country. In: BMC Cancer. 2014 ; Vol. 14, No. 1.
@article{a4b97ee6760f4b5e865308ba9741e9a7,
title = "Closing the global cancer divide- performance of breast cancer care services in a middle income developing country",
abstract = "Background: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.Methods: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.Results: Seven hundred and fifty seven patients were included in the study; they represent about 20{\%} of incident BC in Malaysia. Performance results were mixed. Late presentation was 40{\%}. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80{\%} of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19{\%} of eligible patients.Conclusions: These performance results are probably acceptable for a middle income country though far below the 95{\%} or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.",
keywords = "Breast cancer, Cancer burden, Developing country, Health policy, Health services research, Health system research, Healthcare quality, Performance measurement",
author = "Lim, {Gerard C C} and Aina, {Emran N.} and Cheah, {Soon K.} and Fuad Ismail and Ho, {Gwo F.} and Tho, {Lye M.} and Yip, {Cheng H.} and Taib, {Nur A.} and Chong, {Kwang J.} and Jayendran Dharmaratnam and Abdullah, {Matin M.} and Mohamed, {Ahmad K.} and Ho, {Kean F.} and Kananathan Ratnavelu and Lim, {Chiao M.} and Leong, {Kin W.} and Wahid, {Ibrahim A.} and Lim, {Teck O.}",
year = "2014",
month = "3",
day = "20",
doi = "10.1186/1471-2407-14-212",
language = "English",
volume = "14",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Closing the global cancer divide- performance of breast cancer care services in a middle income developing country

AU - Lim, Gerard C C

AU - Aina, Emran N.

AU - Cheah, Soon K.

AU - Ismail, Fuad

AU - Ho, Gwo F.

AU - Tho, Lye M.

AU - Yip, Cheng H.

AU - Taib, Nur A.

AU - Chong, Kwang J.

AU - Dharmaratnam, Jayendran

AU - Abdullah, Matin M.

AU - Mohamed, Ahmad K.

AU - Ho, Kean F.

AU - Ratnavelu, Kananathan

AU - Lim, Chiao M.

AU - Leong, Kin W.

AU - Wahid, Ibrahim A.

AU - Lim, Teck O.

PY - 2014/3/20

Y1 - 2014/3/20

N2 - Background: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.Methods: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.Results: Seven hundred and fifty seven patients were included in the study; they represent about 20% of incident BC in Malaysia. Performance results were mixed. Late presentation was 40%. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80% of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19% of eligible patients.Conclusions: These performance results are probably acceptable for a middle income country though far below the 95% or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.

AB - Background: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.Methods: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.Results: Seven hundred and fifty seven patients were included in the study; they represent about 20% of incident BC in Malaysia. Performance results were mixed. Late presentation was 40%. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80% of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19% of eligible patients.Conclusions: These performance results are probably acceptable for a middle income country though far below the 95% or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.

KW - Breast cancer

KW - Cancer burden

KW - Developing country

KW - Health policy

KW - Health services research

KW - Health system research

KW - Healthcare quality

KW - Performance measurement

UR - http://www.scopus.com/inward/record.url?scp=84899075164&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899075164&partnerID=8YFLogxK

U2 - 10.1186/1471-2407-14-212

DO - 10.1186/1471-2407-14-212

M3 - Article

C2 - 24650245

AN - SCOPUS:84899075164

VL - 14

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 212

ER -