ESMO Management and treatment adapted recommendations in the COVID-19 era : Breast Cancer
Azambuja, Evandro de (Institut Jules Bordet and l'Université Libre de Bruxelles)
Trapani, Dario (European Institute of Oncology)
Loibl, Sibylle (GBG Forschungs GmbH)
Delaloge, Suzette (Gustave Roussy and Paris-Saclay University)
Senkus, Elzbieta (Department of Oncology and Radiotherapy. Medical University of Gdańsk)
Criscitiello, Carmen (European Institute of Oncology)
Poortman, Philip (Iridium Kankernetwerk and University of Antwerp)
Gnant, Michael (Medical University of Vienna)
Di Cosimo, Serena (Fondazione IRCCS Istituto Nazionale dei Tumori)
Cortés Castán, Javier (Vall d'Hebron Institut d'Oncologia)
Cardoso, Fatima (Champalimaud Clinical Center)
Paluch-Shimon, Shani (Shaare Zedek Medical Centre)
Curigliano, Giuseppe (Department of Oncology and Hemato-Oncology. University of Milano)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2020
Resumen:	The global preparedness and response to the rapid escalation to severe acute respiratory syndrome coronavirus (SARS-CoV)-2-related disease (COVID-19) to a pandemic proportion has demanded the formulation of a reliable, useful and evidence-based mechanism for health services prioritisation, to achieve the highest quality standards of care to all patients. The prioritisation of high value cancer interventions must be embedded in the agenda for the pandemic response, ensuring that no inconsistency or discrepancy emerge in the health planning processes. The aim of this work is to organise health interventions for breast cancer management and research in a tiered framework (high, medium, low value), formulating a scheme of prioritisation per clinical cogency and intrinsic value or magnitude of benefit. The public health tools and schemes for priority setting in oncology have been used as models, aspiring to capture clinical urgency, value in healthcare, community goals and fairness, while respecting the principles of benevolence, non-maleficence, autonomy and justice. We discuss the priority health interventions across the cancer continuum, giving a perspective on the role and meaning to maintain some services (undeferrable) while temporarily abrogate some others (deferrable). Considerations for implementation and the essential link to pre-existing health services, especially primary healthcare, are addressed, outlining a framework for the development of effective and functional services, such as telemedicine. The discussion covers the theme of health systems strategising, and why oncology care, in particular breast cancer care, should be maintained in parallel to pandemic control measures, providing a pragmatic clinical model within the broader context of public healthcare schemes.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article de revisió ; Article ; Versió publicada
Materia:	COVID-19 ; SARS-CoV-2 ; Coronavirus
Publicado en:	ESMO open, Vol. 5 (20 2020) , p. e000793, ISSN 2059-7029

DOI: 10.1136/esmoopen-2020-000793
PMID: 32439716

12 p, 615.6 KB

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