ESMO Open. The results of this study indicate that BC patients in Vietnam incurred significant OOP costs and the cost of BC treatment was driven by theuse of therapies and presentation stage at diagnosis. Brando M, Morais S, Lopes-Conceio L, Fontes F, Arajo N, Dias T, et al. Several studies have investigated the impact of the time interval between the onset of breast cancer symptoms and the start of cancer treatment on prognosis and showed that delays in diagnosis and treatment increased the chances of cancer diagnosis at a late stage, which led to more aggressive treatment and poor survival. Ultrasound can help a radiologist determine whether the abnormality on the mammogram is cystic or solid. St. Francis Cancer Center | Colorado Springs | Centura - Centura Health For each of the utilised services, respondents reported how much was the OOP expense by answering the question What were the costs you paid for that service?. Margaret West Comprehensive Breast Center - West - West Cancer Center In Vietnam, cancer of the lung, stomach, liver, colon-rectum and nasopharynx are the most frequent in males and cancer of the breast, cervix uteri, stomach, colon-rectum and lung are the most frequent in females. Significant association between breast density, menopause status, number of pregnancies, number of babies born, hormone use and levels of physical activity with breast cancer in Vietnamese women. The National Cancer Control Programme offers free screening for all women [clinical breast examination (CBE), ultrasound, and mammography in case of referral], but information was not found on either its broader coverage or strategies for scaling up existing programmes. Although the method used for imputation was technically sound and several pre-cautionary steps were taken to obtain the best reliable imputed values, there remains a possibility of bias. Breast Surgery Dubin Breast Center. USA: https://doi.org/10.18434/M32189. Breast Center | The University of Kansas St. Francis Campus All authors contributed to the interpretation of the findings. Staged Reconstruction (delayed-immediate reconstruction) -To preserve the breast area for future reconstructive surgery, a tissue expander or breast implant is inserted under the chest muscle and preserved breast skin after mastectomy temporarily to preserve the breasts shape and skin during therapy. The Ministry of Health has developed long-term goals, including the extension of screening programmes and building systemic capacity for diagnosis and treatment (both in facilities and in human resources) [16], but, as highlighted by Trieu et al., In Vietnam, despite increased health care and public awareness, a breast cancer national control program as recommended by the WHO has not yet been established [21]. This study presents patient-reported direct payment to health care providers at time-of-service use (excluding the amount covered by SHI, if any) which is the costs of BC D&T from a patient perspective. Data collection were conducted by TTN and NBN. Chris Jenkins managed the production of this paper, leading the drafting and data analysis processes. In one study, 10.2% of eligible patients received no treatment after diagnosis [28]. It is important to note that the analysis was based on a sample in which the proportion of patients diagnosed at early stage (0/I/II) was much higher than the national average of 50.5% [29] though the age of respondents was consistent with other studies [30, 31]. Breast Cancer Surgery | Saint Francis Memorial Hospital | Dignity Therefore, respondents reported the lump sum of all health services related to diagnosis that they received rather than the cost of each individual service by answering the question What were the costs you paid for health services related to examination and diagnosis?. Margaret West Comprehensive Breast Center expanded to a 2nd screening location on January 1, 2023 with the purchase of Dr. Christine Mroz's clinic. Cost of treatment for breast cancer in Central Vietnam. The scope and range of the articles in this review show that there is a relative lack of data related to detection, diagnostic and treatment services for breast cancer in Vietnam. Beyond a lack of systemic capacity, the number of women using screening and detection services may be related to low levels of public awareness and education about detection, symptoms, where to access services and how to conduct self-examination. While initiatives for screening have been implemented by Government and other agencies, few screening programmes have been evaluated. sharing sensitive information, make sure youre on a federal 2019;15(8):e666e76. Dr. Erika Rager, MD - Breast Surgery Specialist in Mooresville, IN Higher costs borne by patients in stage II/III is understandable as their utilisation of mastectomy, chemotherapy, and radiotherapy, which accounted for nearly two-third of the total cost, was significantly higher than stage 0/I patients. Our breast cancer team includes highly-rated and experienced breast surgeons. We work closely with other cancer specialists on recommended treatment plans to provide each patient the best care possible. Cancer (Oncology) | Catholic Health Two national level hospitals, one in Hanoi (K Hospital) and the other in Ho Chi Minh City (HCM Cancer Hospital), provide the majority of specialised cancer treatment. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. However, healthcare providers are allowed to sell services not covered by SHI (i.e., service-on-demand) and clinicians can prescribe drugs that are not covered by SHI [14, 15]. Patients may use these services several times at different hospitals before starting the treatment [21]. Breast Health | St. Francis - Emory Healthcare However, the representativeness and currency of the data which was from 2001-2006 for only one tertiary hospital in central Vietnam call into question its relevance. Studies were localised, and projects (for example related to screening) tended to be local or regional. Tollestrup K, Frost FJ, Stidley CA, Bedrick E, McMillan G, Kunde T, et al. and transmitted securely. 2005;11(11):73040. We offer the following types of imaging for breast health at locations across eastern Oklahoma: Clinical breast exams, in which a gynecologist feels your breast to check for lumps or other areas of concern, is recommended for women ages 25 to 39 every one to three years. General Statistics Office. Respondent characteristics are presented in Table1. This paper constitutes a component of a project undertaken between Queens University Belfast, the Hanoi Medical University and the Hanoi University of Public Health to strengthen breast cancer services in Vietnam. Salampessy BH, Alblas MM, Portrait FRM, Koolman X, van der Hijden EJE. Diagnosis accounted for the smallest share in total cost (2%) with a mean cost of 2.6 million VND ($112). 2015. More than 200,000 adults will be diagnosed with breast cancer every year. Request An Appointment Overview Providers At This Location Conditions & Specialties Treatments & Procedures Overview The Franciscan Physician Network Breast Specialists in Indianapolis provide a number of procedures for breast cancer, including mastectomy, genetic testing, and breast conservation and reconstructive surgery. Costs of breast cancer treatment incurred by women in Vietnam Treatment options across the country widely vary depending on geographic location, with a strong rural/urban difference [21], and while most provincial hospitals officially provide surgical services, as of 2008 (more recent information not found), 10 of them stated that they could not offer this service and regularly referred patients elsewhere [33]. Butler Pavilion, Suite A-001 2300 Manchester Expressway The site is secure. Privacy 2019;19(1):318. Sun L, Legood R, Dos-Santos-Silva I, Gaiha SM, Sadique Z. 2013;96:25863. Cancer challenges and national cancer control programs to 2020. government site. American College of Radiology (ACR) has designated Saint Francis Breast Care Center a Breast Imaging Center of Excellence. Between 2008 and 2015, the National Cancer Control Programme screened an estimated 100,000 women aged 3054 for breast and cervical cancer [15]. Surgical interventions should take place at national and provincial levels; Benign tumours can be surgically removed at district level. The authors describe how CBE has been the primary screening and detection method across six provinces where cancer registries were established in 2008. To avoid biased parameter estimates if applying listwise deletion or complete-case analysis for this large number of missing observations [25, 26], we used a multiple imputation technique to impute missing values. Accessibility Breast MRI diagnoses certain breast cancers at an earlier stage. Related questions (extracted from the questionnaire) were used to estimate the cost of breast cancer diagnosis and initial treatment. In: NTK T, Tuan PL, Long NH, Thanh PT, Bales S, editors. Liao XZ, Shi JF, Liu JS, Huang HY, Guo LW, Zhu XY, et al. We analysed data from a 2019 study of medical expenses and health-related quality of life of women with BC through an online survey and a hospital-based face-to-face survey. The final step in our methodological approach involved charting all eligible documents in terms of the organisational categories of screening and detection, diagnosis and treatment. Guidelines suggest that tamoxifen should be used in hormone therapy for low- and middle-income settings [10]. 2016;19(6):9038. The results of the scoping review suggest that primary care is under-utilised and that patients tend to seek cancer services at a tertiary care level [36] and often when the cancer is at an advanced stage. In other words, patient-level costing allows the comparison of costs between subgroups (defined by stage at diagnosis and treatment options) as well as the identification of cost drivers. While some studies provide data on the numbers of women screened under various programmes there are very few data concerning how these programmes were organised and what methods were used. Responsible Editor Stig Wall, Ume University, Sweden. Maintaining a healthy weight through proper nutrition and exercise is critical to a womans health. You can access your records and more by logging in or signing up with Dignity Health. Conclusions: This paper is the first scoping review of breast cancer services in Vietnam. 100 Charleston, SC 29414 (843) 606-7020 VIEW FULL PROFILE Megan Baker, MD Breast Surgery Roper St. Francis Physician Partners Breast Surgery 3510 Highway 17 N., Ste. There were two possible scenarios: 1) patients chose intentionally not to use SHI and opted to access service- on-demand at public hospitals or services at private hospitals (patients pay 100% OOP) which tended to be viewed as providing better quality healthcare; 2) patients could not use SHI for services which were not covered. Article In turn, the results will help decision-making by policymakers regarding health system financing and service delivery. The higher costs of later cancer stage emphasise the importance of early detection through screening programme. 2018;14(3):16778. Results of a controlled trial, http://creativecommons.org/licenses/by/4.0/, http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#heading-Zero, http://globocan.iarc.fr/Pages/fact_sheets_population.aspx, http://www.wpro.who.int/health_services/health_systems_framework/en/, https://data.worldbank.org/indicator/SP.URB.TOTL.IN.ZS?locations=VN, http://www.tandfonline.com/doi/full/10.3402/gha.v6i0.18872, http://sdh.hmu.edu.vn/news/cID60_Nghien-cuu-hieu-qua-hoa-tri-bo-tro-truoc-phau-thuat-phac-do-AP-trong-ung-thu-vu-giai-doan-III.html, Meeting inclusion criteria (keywords: Breast Cancer & Vietnam (English) and Breast Cancer (Vietnamese) in the title), Risk factors of female breast cancer in Vietnam: a case-control study, Significant association between breast density, menopause status, number of pregnancies, number of babies born, hormone use and levels of physical activity with breast cancer in Vietnamese women, Body mass index, lower parity, and later first childbirth all associated with breast cancer, Four or more births significantly reduced the chance of breast cancer, No significant difference between breast cancer and age at menarche, age at first parity, total months breastfeeding, oral contraceptive use, and menopause, Breast cancer is the most common cancer for women in Vietnam. The maximum value with and without outliers was 824 million VND ($35,554) and 17 million VND ($734), respectively. It was approved by the Ethics Committee of Hanoi University of Public Health (No. Although the sample contains a higher proportion of individuals with higher education level and from urban areas if compare with the national data, the poor and near poor were well represented in the sample. Get the best preventative care and cancer treatment in Tulsa at Saint Francis Health System. We compared recommendations from the guidelines with the results from our review, and by identifying discrepancies and gaps we sought to make recommendations for future areas of focus to strengthen Vietnams response to breast cancer. The We Care For Her campaign is implemented by the Cancer Patient Support Fund, Bright Future, and supported by the Swiss Embassy in Vietnam and the Roche Group. The provision and delivery of information about the availability of breast cancer services in primary and community care would strengthen the health system overall. Directions. Cost of diagnosis contained the highest number of extreme outliers. Methods: We undertook a scoping study using a five-stage framework to review published and grey literature in English and Vietnamese on breast cancer detection, diagnosis and treatment. The outliers likely reflect patients having to go through multiple tests at different hospitals before reaching the definitive diagnosis of BC [21]. Strengthening prevention and control of non-communicable disease, We care for her campaign (VN) [Internet]. As the leading Lowcountry provider of breast cancer services, Roper St. Francis Cancer Care offers state of the art diagnosis and treatment to the women of the Lowcountry who develop breast cancer. These services were expanded to reach 12,000 women in Hanoi, Da Nang and Ho Chi Minh City in 20152016 [17]. Roper St. Francis Cancer Care provides services for more than 2,500 newly diagnosed cancer patients each year. This work was supported by a British Council Newton Grant (Institutional Links) under Grant number: 216383378. Ngan TT, Van Minh H, Donnelly M, ONeill C. Financial toxicity due to breast cancer treatment in low- and middle-income countries: evidence from Vietnam. TTN, MD, and CON contributed to the study conception and design. Columbus, GA 31904, Phone: Radiologists and surgeons are on site to collaborate on breast cancer cases and patients receive timely feedback on mammography test results. While language barriers (and other barriers not relevant in a Vietnamese context) may partly explain these discrepancies, information about other barriers and perceptions may prove indicative and may help inform research in Vietnam. 2016; Available from: http://www.cancercontrol.info/cc2016/cancer-control-in-vietnam-where-we-are/. The trend is similar though higher than the pooled result from a systematic review of global treatment costs of BC by stage in which the rate was 32 and 95% respectively [13]. Further research on how the utilisation of SHI affects the various aspects of treatment (e.g., waiting time, length of treatment, quality, and cost) is needed to generate appropriate policy recommendations for better treatment outcomes. The doctors and staff are passionate about offering not just breast imaging but proactively providing breast health services. Thus, using patient-level data in the calculation of costs (rather than calculating according to clinical guideline-informed treatment pathways) can reveal between-patient heterogeneity [13]. Saint Francis Health System, based in Tulsa, OK, treats breast cancer and raises community awareness about the disease to help increase survival rates. For example, the unit cost of mastectomy regulated by the Ministry of Health in 2018 was 4.7 million VND ($204) [24]. All respondents (100%) used SHI to pay for targeted therapy cost. Vietnams current practice seems to be in line with this recommendation. 2023 BioMed Central Ltd unless otherwise stated. You can make an appointment by calling 573-331-5111. Call (309) 683-5522. Cite this article. Even the best equipment cant save lives without talented, dedicated professionals. Financial autonomy of hospitals and provider payments based on fee-for-service scheme can lead to induced demand by providers in the types of overprescribe drugs, overprescribe diagnosis tests plus test repetition when patients move from a hospital to another, and prolong in-patient stay. Two further papers, including one retrospective study on stages of diagnosis across five hospitals in 2009, found that 49.5% of the women were diagnosed with Stage III or IV breast cancer [15], while 67.7% in the second study were diagnosed at Stage II [30]. Hanoi has almost double the incidence of Ho Chi Minh City, The role, efficacy, feasibility of neoadjuvant AP regimen in inoperable stage III breast cancer (PhD thesis), By using AP regimen as neoadjuvant chemotherapy, the survival of the patients with inoperable stage III breast cancer was improved, Costutility analysis of Trastuzumab in treatment of metastatic HER2-positive breast cancer in Vietnam, The treatment of metastatic HER2-positive breast cancer with Trastuzumab is considered cost-effective in Vietnam, From 2004 to 2008, the prevalence of breast cancer increased rapidly from the age of 30 to 34 and peaked at 5559 at the rate of 135.0/100,000 people, Survival rates for breast cancer in Vietnam is lower than other countries of similar socio-economic level and that have similar stages of diagnosis, Married women with breast cancer have a significantly lower survival rate than unmarried women, and women diagnosed at later stages had worse survival rates, Direct medical costs for the treatment of breast cancer in Vietnam were estimated at $975 per patient (range: $11.73955), Patients without health insurance had significantly lower levels of service utilisation, Costs do not differ for patients diagnosed early or late, but survival times differ significantly, Implementation of a CBE programme for women aged 4055 would increase life years gained, CBE screening in Vietnam, by WHO criteria, is considered a cost-effective screening intervention, Breast cancer and risk factors related to family history in Vietnamese women, Approximately 10% of breast cancers are inherited The rate of breast cancer is higher in those who smoke, drink alcohol, live in rural areas and have higher BMI, but the difference was not significant, Breast cancer is often diagnosed late in Vietnam, Demonstrated effectiveness in curative treatments, with low recurrence and high five-year survival, Factors related to breast cancer knowledge of women in Binh Dinh province in 2010, General knowledge and awareness of symptoms and signs of breast cancer was low, Women who have mothers, sisters and daughters with breast cancer were at higher risk than those who have no family history of breast cancer, Additional published articles included within analysis (keywords not in title), 49.5% of women diagnosed at Stages III & IV, Screening campaigns are costly, and emphasis should be put on increasing levels of awareness of symptoms and treatment options, High costs for patients and partial insurance coverage leads to high levels of treatment non-completion, Knowledge of cancer prevention in Quang Binh province, Knowledge about the risk of breast cancer was limited, Knowledge about signs or symptoms of breast cancer was also low, Increased risk of breast cancer in women with menstruation after 18years of age; the first births over 20years old are statistically significant, Cancer challenges and national cancer control programs to 2020 (Vietnam), The breast cancer incidence in Vietnam has increased steadily over the last decade from a crude rate of 13.8 per 100,000 women in 2000 to 29.9 per 100,000 women in 2010, with an estimated 12,533 breast cancer cases in the country. We found evidence of at least three large-scale localised, provincial and regional screening programmes that have been implemented in Vietnam. Breast cancer treatment costs in younger, privately insured women. Stage of diagnosis strongly correlated with treatment outcomes, with women diagnosed at earlier stages having better survival rates and fewer complications from treatment. Their office is not accepting new patients. [Cited Dec 12, 2020]. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Google Scholar. Breast Cancer Support Groups Despite this possible reduction, however, breast cancer still accounts for over 20% of cancers in women in Vietnam [5], and there is an absence of national data on survival and mortality. The estimated number of breast cancer cases in 2020 is 38.1 per 100,000, Results of national cancer program 20082010, 9 of 63 provincial hospitals had no functioning pathology departments and 10 cannot admit patients with cancer. The choice of covariates that were used to explain variation in costs was based on previous studies [11, 13]: stage of cancer at diagnosis, SHI reimbursement rate, age, household monthly income, and education level. New York: John Wiley & Sons, Inc.; 1987. P T. 2012;37(1):4555. Additional Information. Methodology. Data on treatment outcomes would be useful within an audit, and as a measure of success within any evaluation. Screening Ultrasound (ABUS)Routine ultrasound is performed for women without symptoms but have been told they have dense breast tissue. Global cancer surgery: delivering safe, affordable, and timely cancer surgery, Cancer control in Vietnam. Patients have access to education and other resources, support and specialists from a multidisciplinary team of experts. Received 2017 Dec 7; Accepted 2018 Jan 24. St. Francis Breast Surgery provides comprehensive breast care, including high-risk screening, breast biopsies, and breast surgeries. Costs of breast cancer treatment incurred by women in Vietnam. Comprehensive Breast Health Saint Francis Breast Care Center provides education, examinations, testing and breast cancer surgery and treatment through its state-of-art facility in the region.
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