Cancer survival in Thailand from 1997 to 2012: Assessing the impact of universal health coverage. (December 2022)

• Record Type: Journal Article
• Authors: Maláková, Kateřina; Cabasag, Citadel J.; Bardot, Aude; Sangrajrang, Suleeporn; Chitapanarux, Imjai; Sripan, Patumrat; Suwanrungruang, Krittika; Pongnikorn, Donsuk; Thongsuksai, Paramee; Sriplung, Hutcha; Soerjomataram, Isabelle
• Is Part Of: Journal of cancer policy. Volume 34(2022)
• Publication Date: 2022-12
• Subjects: Breast cancer -- Cervical cancer -- Colorectal cancer -- Incidence -- Survival -- Thailand; ASR Age standardized incidence rate -- BSE self-breast examination -- CBE clinical breast exams -- CT Computerized tomography -- ICD International Classification of Diseases -- MRI Magnetic resonance imaging -- NS Net survival -- UHC Universal Health Coverage -- WCPP World Cancer Patient Population; Cancer -- Government policy -- Periodicals; Cancer -- Patients -- Services for -- Periodicals; Medical Oncology -- Periodicals; Public Health -- Periodicals; Cancer; Periodicals; 362.196994
• DOI: 10.1016/j.jcpo.2022.100353
• Languages: English
• ISSNs: 2213-5383

Abstract

Abstract: Background: In recent decades, many countries worldwide have implemented some form of Universal Health Coverage (UHC). We sought to evaluate incidence and survival trends of breast, cervical, and colorectal cancer before and after the implementation of UHC in Thailand. Methods: The age-standardized incidence rate and 1- and 5-year net survival (NS) were calculated for five Thai provinces, namely Bangkok, Chiang Mai, Khon Kaen, Lampang, and Songkhla for breast, cervix, and colorectal cancer in three study periods (1997–2012): before, during, and after the implementation of UHC. Results: The incidence of breast and colorectal cancer has increased over time, while the incidence of cervical cancer has decreased (17.9–29.9, 9.0–13.6, and 19.6–12.3 per 100, 000, respectively). Larger proportion of breast cancer were diagnosed with localized stage after UHC implementation compared to the period prior to UHC (31.5 % vs 19.0 %). Overall, The improvement in survival by cancer site varied in magnitude with a 5-year NS increase from 61.3 % to 75.1 % for breast, 55.4–59.5 % for cervical, and 39.9–47.6 % for colorectal cancer. The amount of increase slightly differed across provinces. Conclusion: Rising incidence for breast and colorectal, and declining cervical cancer may partly be attributable to improved awareness and early detection programs. Additionally, improvement in survival may partly be attributable to increased access to healthcare, availability of treatment, and increased access to cancer screening after UHC was implemented. Thus, continued expansion of UHC package on cancer could potentially contribute to further improvement of cancer control in Thailand. Policy summary: This study provides important evidence on the impact of UHC in cancer burden and survival for breast, cervical, and colorectal cancer in Thailand. This study serves as an example for other countries where UHC has been recently implemented and guide policymakers in allocating resources towards UHC and cancer control programs. Highlights: Larger percent of early-stage breast cancer were diagnosed after Universal Health Coverage. Breast and colorectal cancer incidence increased between 1997 and 2012 in Thailand. During the study period cervical cancer incidence decreased in the country. Survival improved overtime for all three cancers but the magnitude differed between provinces. This study demonstrates the impact of Universal Health Coverage in three main cancers.