Cancer care underuse, overuse, and inequalities

Area of Science:

• Oncology
• Health Services Research
• Public Health

Background:

• Significant socioeconomic disparities in cancer outcomes persist globally.
• Healthcare resources are often misallocated to low-value interventions, including overdiagnosis and overtreatment.
• Both underuse and overuse of medical cancer care contribute to healthcare inefficiency.

Purpose of the Study:

• To examine healthcare inefficiencies through the lens of simultaneous underuse and overuse of cancer care.
• To propose a novel perspective and roadmap for addressing these dual challenges.
• To highlight the interconnectedness of underuse and overuse in shaping cancer care delivery.

Main Methods:

• Analysis of existing evidence on healthcare inefficiencies in cancer care.
• Conceptual framework examining socioeconomic factors, healthcare system organization, and medical practices.
• Identification of challenges in measuring low-value cancer care.

Main Results:

• Underuse and overuse of cancer care stem from similar underlying mechanisms.
• The coexistence of underuse and overuse represents interconnected aspects of healthcare inefficiency.
• The magnitude and consequences of underuse and overuse are vast, causing substantial harm and impacting health system sustainability.

Conclusions:

• Addressing simultaneous underuse by underserved populations and overuse by well-resourced groups is essential.
• A comprehensive roadmap is needed to tackle these complex inefficiencies in cancer care.
• Reforming healthcare systems is critical to mitigate harm and ensure sustainability.