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Advanced Breast Cancer Guidelines in Latin America: Assessment, Adaptation, and Implementation of Fifth Advanced
Fernando Valencia1, Henry L Gómez2, Silvia P Neciosup3
1Universidad Católica Santa Maria, Arequipa, Peru.
JCO Global Oncology
|February 1, 2024
Summary
Latin American experts highly agree with advanced breast cancer (ABC5) guidelines, but 12 recommendations face access barriers due to cost, technology, and testing limitations. Improving access is crucial for better patient outcomes.
Area of Science:
- Oncology
- Public Health
- Health Policy
Background:
- The fifth international consensus (ABC5) provides guidelines for advanced breast cancer management.
- Latin America faces unique challenges in implementing global cancer care standards.
Purpose of the Study:
- To assess the applicability of ABC5 recommendations in Latin America.
- To identify barriers to accessing advanced breast cancer treatments and diagnostics in the region.
Main Methods:
- A panel of 15 Latin American breast cancer experts discussed 61 ABC5 recommendations.
- Consensus levels were determined by voting, and access to each recommendation was evaluated by country and health system.
Main Results:
- High expert agreement (83%-100%) with ABC5 recommendations was observed.
- Twelve of 61 recommendations are not universally accessible in Latin America.
- Key access barriers include limited advanced technologies (SBRT, PET-CT), high drug costs (CDK4/6 inhibitors, pertuzumab, PARP inhibitors), lack of molecular testing, and geographical/cultural diversity.
Conclusions:
- While ABC5 guidelines are highly relevant, significant disparities in access to advanced breast cancer care persist in Latin America.
- A call to action is issued to policymakers and patient advocacy groups to enhance equitable access and improve clinical outcomes for patients with advanced breast cancer.
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