Our thanks to Mark for alerting us to the Lancet Oncology Commission on Cancer in the Commonwealth. Below are selected extracts.
Section 11: Patient and public engagement
Patient engagement requires active involvement of patients at every stage of their health-care journey, from initial diagnosis to survivorship...
Patient advocacy empowers individuals and communities to inform and influence cancer care policies, shape research, improve access to care, promote patient-centred approaches to care, and help reduce care disparities...
Patient navigation for cancer control — evidence-informed effective interventions to assist patients with cancer to overcome barriers in accessing health care and social services — is another area that is highly cost-effective and leads to higher treatment completion rate, improved quality of care, patient satisfaction, dignity, and outcomes...
Peer support systems, often referred to as buddy systems, are a further novel approach enabling patient engagement in decision making and have proved invaluable in enhancing patient care...
We propose four actions related to patient and public engagement in the Commonwealth. First, institutionalise patient and civil society representation in cancer policy making at national and sub-national levels mandated through NCCP governance arrangements to ensure legitimate advocacy. Second, embed shared decision making as a standard of care in oncology, by incorporating it in national clinical guidelines supported by cultural adaptation and for use in training for oncology, primary care, and palliative care teams. Third, establish cancer patient navigation as an essential element of cancer services across diagnosis, treatment, survivorship, and palliative care. Finally, integrate structured peer support and buddy programmes as a standard component of psychosocial and survivorship care for cancer.
Section 12: Education and professional development
Education and development must address preservice education, recruitment and retention, and continuing professional development of health professions and health literacy of all stakeholders involved in cancer control...
Health literacy, the ability to acquire, internalise and use information to make appropriate decisions about one's own health care or of cared ones is vital for shared decision making... Health literacy of people living with cancer and their carers helps to improve their understanding of the illness, participation in cancer screenings, and adherence to complex multimodal therapies...
Public education underpins health literacy that helps to improve success of prevention initiatives aimed at risk reduction (eg, tobacco use) and vaccine uptake (eg, HPV), participation in population-based screening programmes, awareness of early symptoms of cancer, early detection, effectiveness of treatment, and defeating the stigma of cancer. Health literacy should not be confined to an understanding of disease but also familiarity of health system, shared decision making, and the optimal ways to facilitate interaction between patients, and public and health professions...
Raising the level of population health literacy should be a priority for Commonwealth policy makers...
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org