Global cancer surgery: delivering safe, affordable, and timely cancer surgery.
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Auteurs : Richard Sullivan [Royaume-Uni] ; Olusegun Isaac Alatise [Nigeria] ; Benjamin O. Anderson [États-Unis] ; Riccardo Audisio [Royaume-Uni] ; Philippe Autier [France] ; Ajay Aggarwal [Royaume-Uni] ; Charles Balch [États-Unis] ; Murray F. Brennan [États-Unis] ; Anna Dare [Canada] ; Anil D'Cruz [Inde] ; Alexander M M. Eggermont [France] ; Kenneth Fleming [Royaume-Uni] ; Serigne Magueye Gueye [Sénégal] ; Lars Hagander [Suède] ; Cristian A. Herrera [Chili] ; Hampus Holmer [Suède] ; André M. Ilbawi [Suisse] ; Anton Jarnheimer [Suède] ; Jia-Fu Ji [République populaire de Chine] ; T Peter Kingham [États-Unis] ; Jonathan Liberman [Australie] ; Andrew J M. Leather [Royaume-Uni] ; John G. Meara [États-Unis] ; Swagoto Mukhopadhyay [États-Unis] ; Shilpa S. Murthy [États-Unis] ; Sherif Omar [Égypte] ; Groesbeck P. Parham [Zambie] ; C S Pramesh [Inde] ; Robert Riviello [États-Unis] ; Danielle Rodin [Canada] ; Luiz Santini [Brésil] ; Shailesh V. Shrikhande [Inde] ; Mark Shrime [États-Unis] ; Robert Thomas [Australie] ; Audrey T. Tsunoda [Brésil] ; Cornelis Van De Velde [Pays-Bas] ; Umberto Veronesi [Italie] ; Dehannathparambil Kottarathil Vijaykumar [Inde] ; David Watters [Australie] ; Shan Wang [République populaire de Chine] ; Yi-Long Wu [République populaire de Chine] ; Moez Zeiton [Royaume-Uni] ; Arnie Purushotham [Royaume-Uni]Source :
- The Lancet. Oncology [ 1474-5488 ] ; 2015.
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Abstract
Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.
DOI: 10.1016/S1470-2045(15)00223-5
PubMed: 26427363
Affiliations:
- Australie, Brésil, Canada, Chili, France, Inde, Italie, Nigeria, Pays-Bas, Royaume-Uni, République populaire de Chine, Suisse, Suède, Sénégal, Zambie, Égypte, États-Unis
- Angleterre, Auvergne-Rhône-Alpes, Grand Londres, Grand Manchester, Hollande-Méridionale, Indiana, Lombardie, Massachusetts, Ontario, Oxfordshire, Rhône-Alpes, Texas, Washington (État), État de New York, État de Rio de Janeiro
- Leyde, Londres, Lyon, Manchester, Milan, Orsay, Oxford, Pékin, Rio de Janeiro, Tianjin, Toronto
- Université d'Oxford, Université de Toronto
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Anderson</name><affiliation wicri:level="2"><nlm:affiliation>University of Washington School of Medicine, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Washington School of Medicine, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Audisio, Riccardo" sort="Audisio, Riccardo" uniqKey="Audisio R" first="Riccardo" last="Audisio">Riccardo Audisio</name><affiliation wicri:level="1"><nlm:affiliation>University of Liverpool, Liverpool, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Liverpool, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Autier, Philippe" sort="Autier, Philippe" uniqKey="Autier P" first="Philippe" last="Autier">Philippe Autier</name><affiliation wicri:level="3"><nlm:affiliation>International Prevention Research Institute, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Prevention Research Institute, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Aggarwal, Ajay" sort="Aggarwal, Ajay" uniqKey="Aggarwal A" first="Ajay" last="Aggarwal">Ajay Aggarwal</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Balch, Charles" sort="Balch, Charles" uniqKey="Balch C" first="Charles" last="Balch">Charles Balch</name><affiliation wicri:level="2"><nlm:affiliation>Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Brennan, Murray F" sort="Brennan, Murray F" uniqKey="Brennan M" first="Murray F" last="Brennan">Murray F. Brennan</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Dare, Anna" sort="Dare, Anna" uniqKey="Dare A" first="Anna" last="Dare">Anna Dare</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Global Health Research, St Michael's Hospital, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Global Health Research, St Michael's Hospital, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="D Cruz, Anil" sort="D Cruz, Anil" uniqKey="D Cruz A" first="Anil" last="D'Cruz">Anil D'Cruz</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. Eggermont</name><affiliation wicri:level="3"><nlm:affiliation>Gustave Roussy Cancer Institute, Villejuif, France; University Paris Sud, Orsay, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Gustave Roussy Cancer Institute, Villejuif, France; University Paris Sud, Orsay</wicri:regionArea><placeName><settlement type="city">Orsay</settlement></placeName></affiliation></author><author><name sortKey="Fleming, Kenneth" sort="Fleming, Kenneth" uniqKey="Fleming K" first="Kenneth" last="Fleming">Kenneth Fleming</name><affiliation wicri:level="4"><nlm:affiliation>Green Templeton College, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Green Templeton College, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Gueye, Serigne Magueye" sort="Gueye, Serigne Magueye" uniqKey="Gueye S" first="Serigne Magueye" last="Gueye">Serigne Magueye Gueye</name><affiliation wicri:level="1"><nlm:affiliation>University Cheikh Anta Diop, Dakar, Senegal; Grand Yoff General Hospital, Dakar, Senegal.</nlm:affiliation><country xml:lang="fr">Sénégal</country><wicri:regionArea>University Cheikh Anta Diop, Dakar, Senegal; Grand Yoff General Hospital, Dakar</wicri:regionArea><wicri:noRegion>Dakar</wicri:noRegion></affiliation></author><author><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Herrera, Cristian A" sort="Herrera, Cristian A" uniqKey="Herrera C" first="Cristian A" last="Herrera">Cristian A. Herrera</name><affiliation wicri:level="1"><nlm:affiliation>Cabinet of the Minister, Ministry of Health, Santiago, Chile; Department of Public Health, School of Medicine, Pontificia Universidad Católica, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Cabinet of the Minister, Ministry of Health, Santiago, Chile; Department of Public Health, School of Medicine, Pontificia Universidad Católica, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Holmer, Hampus" sort="Holmer, Hampus" uniqKey="Holmer H" first="Hampus" last="Holmer">Hampus Holmer</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Ilbawi, Andre M" sort="Ilbawi, Andre M" uniqKey="Ilbawi A" first="André M" last="Ilbawi">André M. Ilbawi</name><affiliation wicri:level="1"><nlm:affiliation>University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Union for International Cancer Control, Geneva, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Union for International Cancer Control, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Jarnheimer, Anton" sort="Jarnheimer, Anton" uniqKey="Jarnheimer A" first="Anton" last="Jarnheimer">Anton Jarnheimer</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Ji, Jia Fu" sort="Ji, Jia Fu" uniqKey="Ji J" first="Jia-Fu" last="Ji">Jia-Fu Ji</name><affiliation wicri:level="3"><nlm:affiliation>Peking University Cancer Hospital and Institute, Beijing, China; Chinese Anti-Cancer Association, Tianjin, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Peking University Cancer Hospital and Institute, Beijing, China; Chinese Anti-Cancer Association, Tianjin</wicri:regionArea><placeName><settlement type="city">Tianjin</settlement></placeName></affiliation></author><author><name sortKey="Kingham, T Peter" sort="Kingham, T Peter" uniqKey="Kingham T" first="T Peter" last="Kingham">T Peter Kingham</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Liberman, Jonathan" sort="Liberman, Jonathan" uniqKey="Liberman J" first="Jonathan" last="Liberman">Jonathan Liberman</name><affiliation wicri:level="1"><nlm:affiliation>McCabe Centre for Law and Cancer, Melbourne, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>McCabe Centre for Law and Cancer, Melbourne, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Leather, Andrew J M" sort="Leather, Andrew J M" uniqKey="Leather A" first="Andrew J M" last="Leather">Andrew J M. Leather</name><affiliation wicri:level="3"><nlm:affiliation>King's Centre for Global Health, King's Health Partners and King's College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King's Centre for Global Health, King's Health Partners and King's College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G" last="Meara">John G. Meara</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Mukhopadhyay, Swagoto" sort="Mukhopadhyay, Swagoto" uniqKey="Mukhopadhyay S" first="Swagoto" last="Mukhopadhyay">Swagoto Mukhopadhyay</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Murthy, Shilpa S" sort="Murthy, Shilpa S" uniqKey="Murthy S" first="Shilpa S" last="Murthy">Shilpa S. Murthy</name><affiliation wicri:level="2"><nlm:affiliation>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA; Department of General Surgery, Indiana University, Bloomington, IN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA; Department of General Surgery, Indiana University, Bloomington, IN</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation></author><author><name sortKey="Omar, Sherif" sort="Omar, Sherif" uniqKey="Omar S" first="Sherif" last="Omar">Sherif Omar</name><affiliation wicri:level="1"><nlm:affiliation>Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Parham, Groesbeck P" sort="Parham, Groesbeck P" uniqKey="Parham G" first="Groesbeck P" last="Parham">Groesbeck P. Parham</name><affiliation wicri:level="1"><nlm:affiliation>Department of Obstetrics and Gynecology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; University of Zambia, Lusaka, Zambia.</nlm:affiliation><country xml:lang="fr">Zambie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; University of Zambia, Lusaka</wicri:regionArea><wicri:noRegion>Lusaka</wicri:noRegion></affiliation></author><author><name sortKey="Pramesh, C S" sort="Pramesh, C S" uniqKey="Pramesh C" first="C S" last="Pramesh">C S Pramesh</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Riviello, Robert" sort="Riviello, Robert" uniqKey="Riviello R" first="Robert" last="Riviello">Robert Riviello</name><affiliation wicri:level="2"><nlm:affiliation>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Rodin, Danielle" sort="Rodin, Danielle" uniqKey="Rodin D" first="Danielle" last="Rodin">Danielle Rodin</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Radiation Oncology, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Santini, Luiz" sort="Santini, Luiz" uniqKey="Santini L" first="Luiz" last="Santini">Luiz Santini</name><affiliation wicri:level="3"><nlm:affiliation>INCA (Brazilian National Cancer Institute), Rio de Janeiro, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>INCA (Brazilian National Cancer Institute), Rio de Janeiro</wicri:regionArea><placeName><settlement type="city">Rio de Janeiro</settlement><region type="state">État de Rio de Janeiro</region></placeName></affiliation></author><author><name sortKey="Shrikhande, Shailesh V" sort="Shrikhande, Shailesh V" uniqKey="Shrikhande S" first="Shailesh V" last="Shrikhande">Shailesh V. Shrikhande</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Shrime, Mark" sort="Shrime, Mark" uniqKey="Shrime M" first="Mark" last="Shrime">Mark Shrime</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Thomas, Robert" sort="Thomas, Robert" uniqKey="Thomas R" first="Robert" last="Thomas">Robert Thomas</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health & Human Services, Melbourne, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Health & Human Services, Melbourne, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Tsunoda, Audrey T" sort="Tsunoda, Audrey T" uniqKey="Tsunoda A" first="Audrey T" last="Tsunoda">Audrey T. Tsunoda</name><affiliation wicri:level="1"><nlm:affiliation>Gyne-Oncology Department, Barretos Cancer Hospital, Barretos, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Gyne-Oncology Department, Barretos Cancer Hospital, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Van De Velde, Cornelis" sort="Van De Velde, Cornelis" uniqKey="Van De Velde C" first="Cornelis" last="Van De Velde">Cornelis Van De Velde</name><affiliation wicri:level="3"><nlm:affiliation>Department of Surgical Oncology, Endocrine and Gastrointestinal Surgery, Leiden University Medical Centre, Leiden, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Endocrine and Gastrointestinal Surgery, Leiden University Medical Centre, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Veronesi, Umberto" sort="Veronesi, Umberto" uniqKey="Veronesi U" first="Umberto" last="Veronesi">Umberto Veronesi</name><affiliation wicri:level="3"><nlm:affiliation>European Institute of Oncology, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>European Institute of Oncology, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Vijaykumar, Dehannathparambil Kottarathil" sort="Vijaykumar, Dehannathparambil Kottarathil" uniqKey="Vijaykumar D" first="Dehannathparambil Kottarathil" last="Vijaykumar">Dehannathparambil Kottarathil Vijaykumar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Gynaecological Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Gynaecological Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Watters, David" sort="Watters, David" uniqKey="Watters D" first="David" last="Watters">David Watters</name><affiliation wicri:level="1"><nlm:affiliation>Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Shan" sort="Wang, Shan" uniqKey="Wang S" first="Shan" last="Wang">Shan Wang</name><affiliation wicri:level="3"><nlm:affiliation>Peking University People's Hospital, Beijing, China; Chinese College of Surgeons, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Peking University People's Hospital, Beijing, China; Chinese College of Surgeons, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wu, Yi Long" sort="Wu, Yi Long" uniqKey="Wu Y" first="Yi-Long" last="Wu">Yi-Long Wu</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangzhou, China; Guangdong Academy of Medical Sciences, Guangzhou, China; Chinese Society of Clinical Oncology, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangzhou, China; Guangdong Academy of Medical Sciences, Guangzhou, China; Chinese Society of Clinical Oncology, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Zeiton, Moez" sort="Zeiton, Moez" uniqKey="Zeiton M" first="Moez" last="Zeiton">Moez Zeiton</name><affiliation wicri:level="3"><nlm:affiliation>Sadeq Institute, Tripoli, Libya; Trauma and Orthopaedic Rotation, North-West Deanery, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Sadeq Institute, Tripoli, Libya; Trauma and Orthopaedic Rotation, North-West Deanery, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Purushotham, Arnie" sort="Purushotham, Arnie" uniqKey="Purushotham A" first="Arnie" last="Purushotham">Arnie Purushotham</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:26427363</idno><idno type="pmid">26427363</idno><idno type="doi">10.1016/S1470-2045(15)00223-5</idno><idno type="wicri:Area/PubMed/Corpus">002986</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002986</idno><idno type="wicri:Area/PubMed/Curation">002916</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002916</idno><idno type="wicri:Area/PubMed/Checkpoint">002916</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002916</idno><idno type="wicri:Area/Ncbi/Merge">002B56</idno><idno type="wicri:Area/Ncbi/Curation">002B56</idno><idno type="wicri:Area/Ncbi/Checkpoint">002B56</idno><idno type="wicri:Area/Main/Merge">002D40</idno><idno type="wicri:Area/Main/Curation">002D40</idno><idno type="wicri:Area/Main/Exploration">002D40</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Global cancer surgery: delivering safe, affordable, and timely cancer surgery.</title><author><name sortKey="Sullivan, Richard" sort="Sullivan, Richard" uniqKey="Sullivan R" first="Richard" last="Sullivan">Richard Sullivan</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London, UK. Electronic address: richard.sullivan@kcl.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Alatise, Olusegun Isaac" sort="Alatise, Olusegun Isaac" uniqKey="Alatise O" first="Olusegun Isaac" last="Alatise">Olusegun Isaac Alatise</name><affiliation wicri:level="1"><nlm:affiliation>Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria.</nlm:affiliation><country xml:lang="fr">Nigeria</country><wicri:regionArea>Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife</wicri:regionArea><wicri:noRegion>Ile Ife</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Benjamin O" sort="Anderson, Benjamin O" uniqKey="Anderson B" first="Benjamin O" last="Anderson">Benjamin O. Anderson</name><affiliation wicri:level="2"><nlm:affiliation>University of Washington School of Medicine, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Washington School of Medicine, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Audisio, Riccardo" sort="Audisio, Riccardo" uniqKey="Audisio R" first="Riccardo" last="Audisio">Riccardo Audisio</name><affiliation wicri:level="1"><nlm:affiliation>University of Liverpool, Liverpool, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Liverpool, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Autier, Philippe" sort="Autier, Philippe" uniqKey="Autier P" first="Philippe" last="Autier">Philippe Autier</name><affiliation wicri:level="3"><nlm:affiliation>International Prevention Research Institute, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>International Prevention Research Institute, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Aggarwal, Ajay" sort="Aggarwal, Ajay" uniqKey="Aggarwal A" first="Ajay" last="Aggarwal">Ajay Aggarwal</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Balch, Charles" sort="Balch, Charles" uniqKey="Balch C" first="Charles" last="Balch">Charles Balch</name><affiliation wicri:level="2"><nlm:affiliation>Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Brennan, Murray F" sort="Brennan, Murray F" uniqKey="Brennan M" first="Murray F" last="Brennan">Murray F. Brennan</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Dare, Anna" sort="Dare, Anna" uniqKey="Dare A" first="Anna" last="Dare">Anna Dare</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Global Health Research, St Michael's Hospital, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Global Health Research, St Michael's Hospital, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="D Cruz, Anil" sort="D Cruz, Anil" uniqKey="D Cruz A" first="Anil" last="D'Cruz">Anil D'Cruz</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. Eggermont</name><affiliation wicri:level="3"><nlm:affiliation>Gustave Roussy Cancer Institute, Villejuif, France; University Paris Sud, Orsay, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Gustave Roussy Cancer Institute, Villejuif, France; University Paris Sud, Orsay</wicri:regionArea><placeName><settlement type="city">Orsay</settlement></placeName></affiliation></author><author><name sortKey="Fleming, Kenneth" sort="Fleming, Kenneth" uniqKey="Fleming K" first="Kenneth" last="Fleming">Kenneth Fleming</name><affiliation wicri:level="4"><nlm:affiliation>Green Templeton College, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Trust, Oxford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Green Templeton College, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Trust, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Gueye, Serigne Magueye" sort="Gueye, Serigne Magueye" uniqKey="Gueye S" first="Serigne Magueye" last="Gueye">Serigne Magueye Gueye</name><affiliation wicri:level="1"><nlm:affiliation>University Cheikh Anta Diop, Dakar, Senegal; Grand Yoff General Hospital, Dakar, Senegal.</nlm:affiliation><country xml:lang="fr">Sénégal</country><wicri:regionArea>University Cheikh Anta Diop, Dakar, Senegal; Grand Yoff General Hospital, Dakar</wicri:regionArea><wicri:noRegion>Dakar</wicri:noRegion></affiliation></author><author><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Herrera, Cristian A" sort="Herrera, Cristian A" uniqKey="Herrera C" first="Cristian A" last="Herrera">Cristian A. Herrera</name><affiliation wicri:level="1"><nlm:affiliation>Cabinet of the Minister, Ministry of Health, Santiago, Chile; Department of Public Health, School of Medicine, Pontificia Universidad Católica, Santiago, Chile.</nlm:affiliation><country xml:lang="fr">Chili</country><wicri:regionArea>Cabinet of the Minister, Ministry of Health, Santiago, Chile; Department of Public Health, School of Medicine, Pontificia Universidad Católica, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Holmer, Hampus" sort="Holmer, Hampus" uniqKey="Holmer H" first="Hampus" last="Holmer">Hampus Holmer</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Ilbawi, Andre M" sort="Ilbawi, Andre M" uniqKey="Ilbawi A" first="André M" last="Ilbawi">André M. Ilbawi</name><affiliation wicri:level="1"><nlm:affiliation>University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Union for International Cancer Control, Geneva, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Union for International Cancer Control, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Jarnheimer, Anton" sort="Jarnheimer, Anton" uniqKey="Jarnheimer A" first="Anton" last="Jarnheimer">Anton Jarnheimer</name><affiliation wicri:level="1"><nlm:affiliation>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Paediatric Surgery and Global Paediatrics, Department of Paediatrics, Lund University, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Ji, Jia Fu" sort="Ji, Jia Fu" uniqKey="Ji J" first="Jia-Fu" last="Ji">Jia-Fu Ji</name><affiliation wicri:level="3"><nlm:affiliation>Peking University Cancer Hospital and Institute, Beijing, China; Chinese Anti-Cancer Association, Tianjin, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Peking University Cancer Hospital and Institute, Beijing, China; Chinese Anti-Cancer Association, Tianjin</wicri:regionArea><placeName><settlement type="city">Tianjin</settlement></placeName></affiliation></author><author><name sortKey="Kingham, T Peter" sort="Kingham, T Peter" uniqKey="Kingham T" first="T Peter" last="Kingham">T Peter Kingham</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Liberman, Jonathan" sort="Liberman, Jonathan" uniqKey="Liberman J" first="Jonathan" last="Liberman">Jonathan Liberman</name><affiliation wicri:level="1"><nlm:affiliation>McCabe Centre for Law and Cancer, Melbourne, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>McCabe Centre for Law and Cancer, Melbourne, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Leather, Andrew J M" sort="Leather, Andrew J M" uniqKey="Leather A" first="Andrew J M" last="Leather">Andrew J M. Leather</name><affiliation wicri:level="3"><nlm:affiliation>King's Centre for Global Health, King's Health Partners and King's College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King's Centre for Global Health, King's Health Partners and King's College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G" last="Meara">John G. Meara</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Mukhopadhyay, Swagoto" sort="Mukhopadhyay, Swagoto" uniqKey="Mukhopadhyay S" first="Swagoto" last="Mukhopadhyay">Swagoto Mukhopadhyay</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Murthy, Shilpa S" sort="Murthy, Shilpa S" uniqKey="Murthy S" first="Shilpa S" last="Murthy">Shilpa S. Murthy</name><affiliation wicri:level="2"><nlm:affiliation>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA; Department of General Surgery, Indiana University, Bloomington, IN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA; Department of General Surgery, Indiana University, Bloomington, IN</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation></author><author><name sortKey="Omar, Sherif" sort="Omar, Sherif" uniqKey="Omar S" first="Sherif" last="Omar">Sherif Omar</name><affiliation wicri:level="1"><nlm:affiliation>Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Parham, Groesbeck P" sort="Parham, Groesbeck P" uniqKey="Parham G" first="Groesbeck P" last="Parham">Groesbeck P. Parham</name><affiliation wicri:level="1"><nlm:affiliation>Department of Obstetrics and Gynecology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; University of Zambia, Lusaka, Zambia.</nlm:affiliation><country xml:lang="fr">Zambie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; University of Zambia, Lusaka</wicri:regionArea><wicri:noRegion>Lusaka</wicri:noRegion></affiliation></author><author><name sortKey="Pramesh, C S" sort="Pramesh, C S" uniqKey="Pramesh C" first="C S" last="Pramesh">C S Pramesh</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Riviello, Robert" sort="Riviello, Robert" uniqKey="Riviello R" first="Robert" last="Riviello">Robert Riviello</name><affiliation wicri:level="2"><nlm:affiliation>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Rodin, Danielle" sort="Rodin, Danielle" uniqKey="Rodin D" first="Danielle" last="Rodin">Danielle Rodin</name><affiliation wicri:level="4"><nlm:affiliation>Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Radiation Oncology, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Santini, Luiz" sort="Santini, Luiz" uniqKey="Santini L" first="Luiz" last="Santini">Luiz Santini</name><affiliation wicri:level="3"><nlm:affiliation>INCA (Brazilian National Cancer Institute), Rio de Janeiro, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>INCA (Brazilian National Cancer Institute), Rio de Janeiro</wicri:regionArea><placeName><settlement type="city">Rio de Janeiro</settlement><region type="state">État de Rio de Janeiro</region></placeName></affiliation></author><author><name sortKey="Shrikhande, Shailesh V" sort="Shrikhande, Shailesh V" uniqKey="Shrikhande S" first="Shailesh V" last="Shrikhande">Shailesh V. Shrikhande</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Shrime, Mark" sort="Shrime, Mark" uniqKey="Shrime M" first="Mark" last="Shrime">Mark Shrime</name><affiliation wicri:level="2"><nlm:affiliation>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Thomas, Robert" sort="Thomas, Robert" uniqKey="Thomas R" first="Robert" last="Thomas">Robert Thomas</name><affiliation wicri:level="1"><nlm:affiliation>Department of Health & Human Services, Melbourne, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Health & Human Services, Melbourne, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Tsunoda, Audrey T" sort="Tsunoda, Audrey T" uniqKey="Tsunoda A" first="Audrey T" last="Tsunoda">Audrey T. Tsunoda</name><affiliation wicri:level="1"><nlm:affiliation>Gyne-Oncology Department, Barretos Cancer Hospital, Barretos, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Gyne-Oncology Department, Barretos Cancer Hospital, Barretos</wicri:regionArea><wicri:noRegion>Barretos</wicri:noRegion></affiliation></author><author><name sortKey="Van De Velde, Cornelis" sort="Van De Velde, Cornelis" uniqKey="Van De Velde C" first="Cornelis" last="Van De Velde">Cornelis Van De Velde</name><affiliation wicri:level="3"><nlm:affiliation>Department of Surgical Oncology, Endocrine and Gastrointestinal Surgery, Leiden University Medical Centre, Leiden, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Endocrine and Gastrointestinal Surgery, Leiden University Medical Centre, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Veronesi, Umberto" sort="Veronesi, Umberto" uniqKey="Veronesi U" first="Umberto" last="Veronesi">Umberto Veronesi</name><affiliation wicri:level="3"><nlm:affiliation>European Institute of Oncology, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>European Institute of Oncology, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Vijaykumar, Dehannathparambil Kottarathil" sort="Vijaykumar, Dehannathparambil Kottarathil" uniqKey="Vijaykumar D" first="Dehannathparambil Kottarathil" last="Vijaykumar">Dehannathparambil Kottarathil Vijaykumar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Gynaecological Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Gynaecological Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Watters, David" sort="Watters, David" uniqKey="Watters D" first="David" last="Watters">David Watters</name><affiliation wicri:level="1"><nlm:affiliation>Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong, VIC</wicri:regionArea><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Shan" sort="Wang, Shan" uniqKey="Wang S" first="Shan" last="Wang">Shan Wang</name><affiliation wicri:level="3"><nlm:affiliation>Peking University People's Hospital, Beijing, China; Chinese College of Surgeons, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Peking University People's Hospital, Beijing, China; Chinese College of Surgeons, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wu, Yi Long" sort="Wu, Yi Long" uniqKey="Wu Y" first="Yi-Long" last="Wu">Yi-Long Wu</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangzhou, China; Guangdong Academy of Medical Sciences, Guangzhou, China; Chinese Society of Clinical Oncology, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangzhou, China; Guangdong Academy of Medical Sciences, Guangzhou, China; Chinese Society of Clinical Oncology, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Zeiton, Moez" sort="Zeiton, Moez" uniqKey="Zeiton M" first="Moez" last="Zeiton">Moez Zeiton</name><affiliation wicri:level="3"><nlm:affiliation>Sadeq Institute, Tripoli, Libya; Trauma and Orthopaedic Rotation, North-West Deanery, Manchester, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Sadeq Institute, Tripoli, Libya; Trauma and Orthopaedic Rotation, North-West Deanery, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Purushotham, Arnie" sort="Purushotham, Arnie" uniqKey="Purushotham A" first="Arnie" last="Purushotham">Arnie Purushotham</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre, London, UK; King's Centre for Global Health, King's Health Partners and King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">The Lancet. Oncology</title><idno type="eISSN">1474-5488</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Delivery of Health Care</term><term>Global Health</term><term>Health Services Needs and Demand</term><term>Humans</term><term>Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Besoins et demandes de services de santé</term><term>Humains</term><term>Prestations des soins de santé</term><term>Santé mondiale</term><term>Tumeurs ()</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Delivery of Health Care</term><term>Global Health</term><term>Health Services Needs and Demand</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Besoins et demandes de services de santé</term><term>Humains</term><term>Prestations des soins de santé</term><term>Santé mondiale</term><term>Tumeurs</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Brésil</li><li>Canada</li><li>Chili</li><li>France</li><li>Inde</li><li>Italie</li><li>Nigeria</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>République populaire de Chine</li><li>Suisse</li><li>Suède</li><li>Sénégal</li><li>Zambie</li><li>Égypte</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Auvergne-Rhône-Alpes</li><li>Grand Londres</li><li>Grand Manchester</li><li>Hollande-Méridionale</li><li>Indiana</li><li>Lombardie</li><li>Massachusetts</li><li>Ontario</li><li>Oxfordshire</li><li>Rhône-Alpes</li><li>Texas</li><li>Washington (État)</li><li>État de New York</li><li>État de Rio de Janeiro</li></region><settlement><li>Leyde</li><li>Londres</li><li>Lyon</li><li>Manchester</li><li>Milan</li><li>Orsay</li><li>Oxford</li><li>Pékin</li><li>Rio de Janeiro</li><li>Tianjin</li><li>Toronto</li></settlement><orgName><li>Université d'Oxford</li><li>Université de Toronto</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Sullivan, Richard" sort="Sullivan, Richard" uniqKey="Sullivan R" first="Richard" last="Sullivan">Richard Sullivan</name></region><name sortKey="Aggarwal, Ajay" sort="Aggarwal, Ajay" uniqKey="Aggarwal A" first="Ajay" last="Aggarwal">Ajay Aggarwal</name><name sortKey="Audisio, Riccardo" sort="Audisio, Riccardo" uniqKey="Audisio R" first="Riccardo" last="Audisio">Riccardo Audisio</name><name sortKey="Fleming, Kenneth" sort="Fleming, Kenneth" uniqKey="Fleming K" first="Kenneth" last="Fleming">Kenneth Fleming</name><name sortKey="Leather, Andrew J M" sort="Leather, Andrew J M" uniqKey="Leather A" first="Andrew J M" last="Leather">Andrew J M. Leather</name><name sortKey="Purushotham, Arnie" sort="Purushotham, Arnie" uniqKey="Purushotham A" first="Arnie" last="Purushotham">Arnie Purushotham</name><name sortKey="Zeiton, Moez" sort="Zeiton, Moez" uniqKey="Zeiton M" first="Moez" last="Zeiton">Moez Zeiton</name></country><country name="Nigeria"><noRegion><name sortKey="Alatise, Olusegun Isaac" sort="Alatise, Olusegun Isaac" uniqKey="Alatise O" first="Olusegun Isaac" last="Alatise">Olusegun Isaac Alatise</name></noRegion></country><country name="États-Unis"><region name="Washington (État)"><name sortKey="Anderson, Benjamin O" sort="Anderson, Benjamin O" uniqKey="Anderson B" first="Benjamin O" last="Anderson">Benjamin O. Anderson</name></region><name sortKey="Balch, Charles" sort="Balch, Charles" uniqKey="Balch C" first="Charles" last="Balch">Charles Balch</name><name sortKey="Brennan, Murray F" sort="Brennan, Murray F" uniqKey="Brennan M" first="Murray F" last="Brennan">Murray F. Brennan</name><name sortKey="Kingham, T Peter" sort="Kingham, T Peter" uniqKey="Kingham T" first="T Peter" last="Kingham">T Peter Kingham</name><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G" last="Meara">John G. Meara</name><name sortKey="Mukhopadhyay, Swagoto" sort="Mukhopadhyay, Swagoto" uniqKey="Mukhopadhyay S" first="Swagoto" last="Mukhopadhyay">Swagoto Mukhopadhyay</name><name sortKey="Murthy, Shilpa S" sort="Murthy, Shilpa S" uniqKey="Murthy S" first="Shilpa S" last="Murthy">Shilpa S. Murthy</name><name sortKey="Riviello, Robert" sort="Riviello, Robert" uniqKey="Riviello R" first="Robert" last="Riviello">Robert Riviello</name><name sortKey="Shrime, Mark" sort="Shrime, Mark" uniqKey="Shrime M" first="Mark" last="Shrime">Mark Shrime</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Autier, Philippe" sort="Autier, Philippe" uniqKey="Autier P" first="Philippe" last="Autier">Philippe Autier</name></region><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. Eggermont</name></country><country name="Canada"><region name="Ontario"><name sortKey="Dare, Anna" sort="Dare, Anna" uniqKey="Dare A" first="Anna" last="Dare">Anna Dare</name></region><name sortKey="Rodin, Danielle" sort="Rodin, Danielle" uniqKey="Rodin D" first="Danielle" last="Rodin">Danielle Rodin</name></country><country name="Inde"><noRegion><name sortKey="D Cruz, Anil" sort="D Cruz, Anil" uniqKey="D Cruz A" first="Anil" last="D'Cruz">Anil D'Cruz</name></noRegion><name sortKey="Pramesh, C S" sort="Pramesh, C S" uniqKey="Pramesh C" first="C S" last="Pramesh">C S Pramesh</name><name sortKey="Shrikhande, Shailesh V" sort="Shrikhande, Shailesh V" uniqKey="Shrikhande S" first="Shailesh V" last="Shrikhande">Shailesh V. Shrikhande</name><name sortKey="Vijaykumar, Dehannathparambil Kottarathil" sort="Vijaykumar, Dehannathparambil Kottarathil" uniqKey="Vijaykumar D" first="Dehannathparambil Kottarathil" last="Vijaykumar">Dehannathparambil Kottarathil Vijaykumar</name></country><country name="Sénégal"><noRegion><name sortKey="Gueye, Serigne Magueye" sort="Gueye, Serigne Magueye" uniqKey="Gueye S" first="Serigne Magueye" last="Gueye">Serigne Magueye Gueye</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name></noRegion><name sortKey="Holmer, Hampus" sort="Holmer, Hampus" uniqKey="Holmer H" first="Hampus" last="Holmer">Hampus Holmer</name><name sortKey="Jarnheimer, Anton" sort="Jarnheimer, Anton" uniqKey="Jarnheimer A" first="Anton" last="Jarnheimer">Anton Jarnheimer</name></country><country name="Chili"><noRegion><name sortKey="Herrera, Cristian A" sort="Herrera, Cristian A" uniqKey="Herrera C" first="Cristian A" last="Herrera">Cristian A. 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Ilbawi</name></noRegion></country><country name="République populaire de Chine"><noRegion><name sortKey="Ji, Jia Fu" sort="Ji, Jia Fu" uniqKey="Ji J" first="Jia-Fu" last="Ji">Jia-Fu Ji</name></noRegion><name sortKey="Wang, Shan" sort="Wang, Shan" uniqKey="Wang S" first="Shan" last="Wang">Shan Wang</name><name sortKey="Wu, Yi Long" sort="Wu, Yi Long" uniqKey="Wu Y" first="Yi-Long" last="Wu">Yi-Long Wu</name></country><country name="Australie"><noRegion><name sortKey="Liberman, Jonathan" sort="Liberman, Jonathan" uniqKey="Liberman J" first="Jonathan" last="Liberman">Jonathan Liberman</name></noRegion><name sortKey="Thomas, Robert" sort="Thomas, Robert" uniqKey="Thomas R" first="Robert" last="Thomas">Robert Thomas</name><name sortKey="Watters, David" sort="Watters, David" uniqKey="Watters D" first="David" last="Watters">David Watters</name></country><country name="Égypte"><noRegion><name sortKey="Omar, Sherif" sort="Omar, Sherif" uniqKey="Omar S" first="Sherif" last="Omar">Sherif Omar</name></noRegion></country><country name="Zambie"><noRegion><name sortKey="Parham, Groesbeck P" sort="Parham, Groesbeck P" uniqKey="Parham G" first="Groesbeck P" last="Parham">Groesbeck P. Parham</name></noRegion></country><country name="Brésil"><region name="État de Rio de Janeiro"><name sortKey="Santini, Luiz" sort="Santini, Luiz" uniqKey="Santini L" first="Luiz" last="Santini">Luiz Santini</name></region><name sortKey="Tsunoda, Audrey T" sort="Tsunoda, Audrey T" uniqKey="Tsunoda A" first="Audrey T" last="Tsunoda">Audrey T. Tsunoda</name></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van De Velde, Cornelis" sort="Van De Velde, Cornelis" uniqKey="Van De Velde C" first="Cornelis" last="Van De Velde">Cornelis Van De Velde</name></region></country><country name="Italie"><region name="Lombardie"><name sortKey="Veronesi, Umberto" sort="Veronesi, Umberto" uniqKey="Veronesi U" first="Umberto" last="Veronesi">Umberto Veronesi</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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