A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy

Jorge Jimenez de la Jara, Gabriel Bastias, Catterina Ferreccio, Cristian Moscoso, Sofia Sagues, Camilo Cid, Eduardo Bronstein, Cristian Herrera, Bruno Nervi, Alejandro Corvalan, Ethel V Velasquez, Pamela Gonzalez, Enrique Castellon, Eva Bustamante, Sergio Oñate, Eileen McNerney, Richard Sullivan, Gareth I Owen, Jorge Jimenez de la Jara, Gabriel Bastias, Catterina Ferreccio, Cristian Moscoso, Sofia Sagues, Camilo Cid, Eduardo Bronstein, Cristian Herrera, Bruno Nervi, Alejandro Corvalan, Ethel V Velasquez, Pamela Gonzalez, Enrique Castellon, Eva Bustamante, Sergio Oñate, Eileen McNerney, Richard Sullivan, Gareth I Owen

Abstract

Introduction: The South American country Chile now boasts a life expectancy of over 80 years. As a consequence, Chile now faces the increasing social and economic burden of cancer and must implement political policy to deliver equitable cancer care. Hindering the development of a national cancer policy is the lack of comprehensive analysis of cancer infrastructure and economic impact.

Objectives: Evaluate existing cancer policy, the extent of national investigation and the socio-economic impact of cancer to deliver guidelines for the framing of an equitable national cancer policy.

Methods: Burden, research and care-policy systems were assessed by triangulating objective system metrics--epidemiological, economic, etc.--with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed.

Results: Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers.

Conclusions: Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

Figures

Figure 1
Figure 1
Chile’s ageing population. Comparison of age cohorts (%) from 1950 projected to 2050 (Data source: CHILE: Proyecciones y Estimaciones de Población. Total País 1950–2050[9]).
Figure 2
Figure 2
Chronic disease burden in Chile. DALY: Disability Adjusted Life Years; YLD: Years Lost due to Disability; YLL: Years Lost due to Death; DALY corresponds to the sum of YLD + YLL (Raw data source: Chilean Ministry of Health) [18].
Figure 3
Figure 3
State-subsidized investment in cancer research in Chile. A) Total Investment in cancer research 2002–2012 (US$ Millions). B) Investment in cancer research (US$ Millions) by year between 2002 and 2012 according to public funding source.
Figure 4
Figure 4
Quantification of cancer researchers in Chile. A) Total number of investigators, separated into highest academic obtained, that have performed cancer research in Chile. B) Total number of investigators, separated into highest academic obtained, who have received national funds for the purposes of cancer research in Chile.
Figure 5
Figure 5
Location of cancer research in Chile. A) Institutional affiliation of cancer-related investigators in Chile. B) Direct national funding received by cancer-related investigators according to institutional affiliation (expressed as percentage of total funding obtained between 2002–2012).
Figure 6
Figure 6
Areas of oncology research in Chile. A) Research categories of cancer-related projects for investigators who have received national funding or participated in national or international clinical trials and protocols. B) Research categories of cancer-related investigation based on financial allocation from national funds between 2002 and 2012.
Figure 7
Figure 7
Chilean cancer publication record (1970–2013). Trends in Chilean scientific cancer-related publications (written in English and Spanish), as indexed in PubMed database.

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Source: PubMed

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