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Disparities in Cancer Diagnosis, Treatment, and Survival
competent manner. This approach must also promote good, culturally Infrastructure, Programs, and Policies
appropriate communication and shared decision-making between the Infrastructure, programs, and policies are the means by which change
cancer survivor and healthcare providers. Cancer treatment is can be made in public health. Infrastructure refers to basic resources
complex and differs for each individual based on his or her specific and facilities to address survivorship, such as healthcare and public
situation and needs. All cancer patients should have timely access to health systems in state and local health departments. Effective
the latest and most effective treatments available, including clinical infrastructure and good relationships with public and private sectors are
trials. Quality care and services includes pain and symptom required to operate and manage effective programs. Programs are
management as well as end-of-life care. The goal of pain and specific activities that aim to improve the quality of life of cancer
symptom management is to provide relief so that survivors can survivors. These programs may address medical, psychosocial, legal,
tolerate the diagnostic and therapeutic procedures needed to treat and financial issues related to cancer survivorship. Policies include
their cancer and live comfortably through each stage of cancer legislation, regulations, ordinances, guidelines, and norms that establish
survivorship. Appropriate end-of-life care affirms life and regards an environment conducive to program implementation and other
dying as a natural process, neither hastening nor postponing death, in changes specific to survivorship. Policies may be implemented at the
order to achieve the best possible quality of life for cancer survivors. national, state, organizational, and community levels in an effort to
advance public health.
The prioritized needs related to access to quality care and services are:
The prioritized needs related to infrastructure, programs, and policies are:
• develop and promote a patient navigation system for cancer survivors;
• develop and disseminate guidelines that promote quality and timely • develop and promote patient navigation programs that facilitate
service provision to cancer survivors; optimum care;
• educate decision-makers about economic healthcare barriers • identify and implement programs proved to be effective;
related to cancer survivors; • develop and disseminate education programs that empower
• establish integrated multidisciplinary teams of healthcare providers survivors to make informed decisions;
that support cancer survivors; and • implement evidence-based cancer plans that include all stages of
• assess and enhance palliative services for cancer survivors. cancer survivorship;
• promote policy changes that support addressing cancer as a
Education, Training, and Communication chronic disease;
Education, training, and communication include efforts to • establish clinical practice guidelines for each stage of cancer
communicate with the general public as well as with policy- and survivorship; and
decision-makers, to educate survivors and their families, and to train • develop infrastructure to obtain quality data on all cancer
healthcare providers to meet the information needs of all those management activities.
affected by cancer survivorship. Survivor education should be tailored
to each particular stage of survivorship. Educational interventions Applied Research and Surveillance
may be most appropriate during the first five years after diagnosis, as Applied research and surveillance are the scientific tools of public
this is the time when many of the challenges associated with the health. They can be used to establish a solid, systematic knowledge
adjustment to survivorship occur. Also included is healthcare provider base in cancer survivorship. Applied research includes cancer
training, which aims to ensure that providers are aware of the medical survivorship research that focuses on applying our knowledge of cancer
and psychosocial needs of cancer survivors. Training should cover all and issues survivors face to the development of solutions and
services necessary to enhance quality of life throughout survivorship. appropriate interventions. Applied research investigates health systems,
Public communication about the issues surrounding cancer public policy, and effects on individuals to address survivor needs.
survivorship that aims to create a societal understanding and Surveillance is the collection, analysis, and use of cancer data.
acceptance of the growing populations of cancer survivors and the Surveillance data are critical for directing effective cancer prevention
issues they face is also necessary. and control programs. Data come from cancer registries that collect
information on each cancer patient. National surveys collect data on
The prioritized needs related to education, training, and communication health attitudes, beliefs, and behaviors that are used to help understand
are: issues related to all stages of cancer survivorship.
• develop and promote patient navigation systems for cancer The prioritized needs related to applied research and surveillance are:
survivors;
• educate healthcare providers about cancer survivorship issues; • identify factors associated with health concerns of cancer survivors;
• educate decision-makers on the value of follow-up care and • identify programs/services that best meet cancer survivorship
clinical trials; needs;
• teach survivors to access and evaluate cancer survivorship • research preventive interventions to evaluate their impact on
information; survivorship;
• train survivors in advocacy skills; and • translate applied research into practice; and
• educate the public about cancer survivorship. • enhance existing surveillance and applied research infrastructure.
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