3 research outputs found
Factors influencing treatment decisionâmaking for cancer patients in lowâ and middleâincome countries: A scoping review
Abstract Purpose In this scoping review, we evaluated existing literature related to factors influencing treatment decisionâmaking for patients diagnosed with cancer in lowâ and middleâincome countries, noting factors that influence decisions to pursue treatment with curative versus nonâcurative intent. We identified an existing framework for adult cancer developed in a highâincome country (HIC) context and described similar and novel factors relevant to lowâand middleâincome country settings. Methods We used scoping review methodology to identify and synthesize existing literature on factors influencing decisionâmaking for pediatric and adult cancer in these settings. Articles were identified through an advanced Boolean search across six databases, inclusive of all article types from inception through July 2022. Results Seventyânine articles were identified from 22 countries across six regions, primarily reporting the experiences of lowerâmiddle and upperâmiddleâincome countries. Included articles largely represented original research (54%), adult cancer populations (61%), and studied patients as the targeted population (51%). More than a quarter of articles focused exclusively on breast cancer (28%). Approximately 30% described factors that influenced decisions to choose between therapies with curative versus nonâcurative intent. Of 56 reported factors, 22 novel factors were identified. Socioeconomic status, reimbursement policies/cost of treatment, and treatment and supportive care were the most commonly described factors. Conclusions This scoping review expanded upon previously described factors that influence cancer treatment decisionâmaking in HICs, broadening knowledge to include perspectives of lowâ and middleâincome countries. While global commonalities exist, certain variables influence treatment choices differently or uniquely in different settings. Treatment regimens should further be tailored to local environments with consideration of contextual factors and accessible resources that often impact decisionâmaking