Financial hardship in families of children or adolescents with cancer: a systematic literature review.

Financial hardship in childhood cancer contributes to poor health outcomes and global disparities in survival, but the extent of the financial burden on families is not yet fully understood. We systematically reviewed financial hardship prevalence and individual components characterising financial hardship across six domains (medical, non-medical, and indirect costs, financial strategies, psychosocial responses, and behavioural responses) and compared characteristics across country income levels using an established theory of human needs. We included 123 studies with data spanning 47 countries. Extensive heterogeneity in study methodologies and measures resulted in incomparable prevalence estimates and limited analysis. Components characterising financial hardship spanned the six domains and showed variation across country income contexts, yet a synthesis of existing literature cannot establish whether these are true differences in characterisation or burden. Our findings emphasise a crucial need to implement a data-driven methodological framework with validated measures to inform effective policies and interventions to address financial hardship in childhood cancer.

Equity in national cancer control plans in the region of the Americas.

Many social determinants that are outside an individual's control affect their exposure to cancer risk factors and access to high-quality care. There is increasing recognition that national cancer control plans are fundamental tools to address cancer burden and promote equitable care. To investigate how policies in the WHO region of the Americas promote equity in cancer care, we evaluated 46 cancer-related health plans covering 34 countries. We analysed and coded the text of the documents according to 40 indicators and three dimensions (context, equity, and governance). Our results suggest that equity is not sufficiently integrated in national cancer control plans in the region. 17 documents defined inequity as a problem mainly related to difficulties in the access to care. Although 25 countries had designed equitable interventions, none had dedicated a budget for their implementation. Countries still need to translate their expressed concern with equity in health into funded, targeted interventions that accompany patients throughout the entire cancer care continuum.