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      Pediatric oncology services in Colombia Translated title: Servicios de oncología pediátrica en Colombia

      research-article
      1 , , 1 , 1 ,
      Colombia Médica : CM
      Universidad del Valle
      Medical care, comprehensive, children, cancer, Colombia, atención, integral, niños, cáncer, Colombia

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          Background:

          In low-income countries, a child diagnosed with cancer has an 80% chance of dying, while in high-income countries more than 80% survive the disease. In Colombia, a middle-income country, the government issued new legislation that promotes the generation of comprehensive care units; nevertheless, seven years after its expedition, no institution has been recognized as such by the Ministry of Health. The objective of this study was to characterize the current offer of oncological services for cancer care in children and to identify the institutions that can be constituted in Units of Comprehensive Care of Childhood Cancer in Colombia.

          Methods:

          descriptive study of secondary source, the Special Register of Health Providers of the Ministry of Health and Social Protection was consulted, in order to identify the institutions that had enabled hospitalization services of medium or high complexity, chemotherapy, specialized consultation, emergencies, oncological surgery, and radiotherapy or nuclear medicine. The information is reported in absolute frequencies.

          Results:

          Seventy one institutions have hematology-oncology consultation, 39 institutions have chemotherapy and hospitalization services of medium or high complexity, and 18 have radiotherapy enabled. Only nine of the institutions include all the services that are necessary for comprehensive care.

          Conclusion:

          Colombia has a sufficient supply of services for the care of children with cancer. Only a minority are in institutions that have the capacity to guarantee the integrality of the attention.

          Resumen

          Antecedentes:

          En los países de bajos ingresos un niño diagnosticado con cáncer tiene un 80% de probabilidad de morir mientras que en los países de ingresos altos más del 80% sobrevive a la enfermedad. En Colombia, un país de ingresos medios, el gobierno expidió una nueva legislación que promueve la generación de unidades de atención integral; sin embargo, siete años después de su expedición, ninguna Institución ha sido reconocida como tal por el Ministerio de Salud.

          Objetivo:

          Caracterizar la actual oferta de servicios oncológicos para atención de cáncer en niños e identificar las instituciones que podrían ser constituirse en Unidades de Atención Integral de Cáncer Infantil en Colombia.

          Métodos:

          estudio descriptivo de fuente secundaria, se consultó el Registro Especial de Prestadores de Salud del Ministerio de Salud y Protección Social; identificando las instituciones que tenían habilitados servicio de hospitalización de mediana o alta complejidad, quimioterapia, consulta especializada, urgencias, cirugía oncológica, radioterapia o medicina nuclear. Se reporta la información en frecuencias absolutas.

          Resultados:

          Setenta y una instituciones cuentan con consulta de hemato-Oncología, 39 instituciones tienen servicios de quimioterapia y hospitalización de mediana o alta complejidad y 18 tienen habilitada radioterapia. Solo nueve de las instituciones incluyen la totalidad de los servicios necesarios para la atención integral.

          Conclusión:

          Colombia cuenta con una oferta suficiente de servicios para atención de niños con cáncer. Solo una minoría se encuentra en Instituciones que tienen la capacidad de garantizar la integralidad de la atención.

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          Most cited references11

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          Toward the Cure of All Children With Cancer Through Collaborative Efforts: Pediatric Oncology As a Global Challenge.

          Advances in the treatment of childhood cancers have resulted in part from the development of national and international collaborative initiatives that have defined biologic determinants and generated risk-adapted therapies that maximize cure while minimizing acute and long-term effects. Currently, more than 80% of children with cancer who are treated with modern multidisciplinary treatments in developed countries are cured; however, of the approximately 160,000 children and adolescents who are diagnosed with cancer every year worldwide, 80% live in low- and middle-income countries (LMICs), where access to quality care is limited and chances of cure are low. In addition, the disease burden is not fully known because of the lack of population-based cancer registries in low-resource countries. Regional and ethnic variations in the incidence of the different childhood cancers suggest unique interactions between genetic and environmental factors that could provide opportunities for etiologic research. Regional collaborative initiatives have been developed in Central and South America and the Caribbean, Africa, the Middle East, Asia, and Oceania. These initiatives integrate regional capacity building, education of health care providers, implementation of intensity-graduated treatments, and establishment of research programs that are adjusted to local capacity and local needs. Together, the existing consortia and regional networks operating in LMICs have the potential to reach out to almost 60% of all children with cancer worldwide. In summary, childhood cancer burden has been shifted toward LMICs and, for that reason, global initiatives directed at pediatric cancer care and control are needed. Regional networks aiming to build capacity while incorporating research on epidemiology, health services, and outcomes should be supported.
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            • Article: not found

            Diagnosis delays in childhood cancer: a review.

            Timely access to quality healthcare has become an increasingly important public health concern over the years. Early diagnosis of cancer is a fundamental goal in oncology because it allows an opportunity for timely treatment while disease burden is still in its earliest stages. Consequently, prognosis may improve, and a cure can be attained with minimal side or late effects. This review examined delays present in diagnosis of childhood cancers and factors that influence these delays. An extensive search of the literature published before April 15, 2007 was conducted for studies that evaluated any type of delay along the cancer-care continuum. Twenty-three studies were included. Diagnosis delay varied across studies. Physician delays were generally longer than those consequent to parents' or patients' recognition of underlying disease. Causes of delays can be grouped into 3 categories: patient and/or parent, disease, and healthcare. The main factors related to diagnosis delay were the child's age at diagnosis, parent level of education, type of cancer, presentation of symptoms, tumor site, cancer stage, and first medical specialty consulted. Greater understanding of factors that influence delays and the individual impact of patient and provider delays on disease severity and prognosis would be useful to form effective policies and programs aimed at ensuring timely access to healthcare for children with cancer.
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              • Record: found
              • Abstract: not found
              • Article: not found

              Saving the children--improving childhood cancer treatment in developing countries.

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                Author and article information

                Journal
                Colomb Med (Cali)
                Colombia Médica : CM
                Universidad del Valle
                0120-8322
                1657-9534
                30 March 2018
                Jan-Mar 2018
                : 49
                : 1
                : 97-101
                Affiliations
                [1 ] Instituto Nacional de Cancerología, Bogota, Colombia
                Author notes
                [Corresponding author: ]Amaranto Suarez Mattos, Instituto Nacional de Cancerología . Cl. 1 #9-85, Telefono +57 (1) 4320160. E-mail: asuarez@ 123456cancer.gov.co

                Conflicts of interest:Nothing

                Article
                10.25100/cm.v49i1.3377
                6018828
                4049d4bf-0636-4e32-9730-3ff543a068ed
                Copyright © 2018 Universidad del Valle

                This article is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use and redistribution provided that the original author and source are credited.

                History
                : 17 July 2017
                : 15 December 2017
                : 12 January 2018
                Page count
                Figures: 2, Tables: 6, Equations: 0, References: 19, Pages: 5
                Categories
                Original Article

                medical care,comprehensive,children,cancer,colombia,atención,integral,niños,cáncer

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