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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 16784

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Special Issue Editors

Dr. Francesco Giusti

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Guest Editor

Umbria Population Cancer Registry, 06100 Perugia, Italy
Interests: cancer epidemiology and registration; healthcare systems; cancer treatment data; cancer data quality
Special Issues, Collections and Topics in MDPI journals

Dr. Carmen Martos

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Guest Editor

Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research (FISABIO), Avda. Catalunya, 21, 46020 Valencia, Spain
Interests: cancer epidemiology; cancer registration; health data quality; rare diseases epidemiology; epidemiology of congenital anomalies; health information systems; health inequalities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Research on health services in cancer care provides valuable information to decision makers to ensure that all people are offered the best and most appropriate care to improve their health.

This Special Issue attempts to highlight this relevant endpoint with the aim of increasing the knowledge on the use, costs, accessibility, quality, organization, financing, and outcomes of health services in cancer care. Researchers and research groups engaged in healthcare or health services in the field of oncology and the cancer care sphere are encouraged to contribute.

The range of topics covered in this Special Issue reflects the multidimensional nature of cancer care and the diverse challenges faced by patients, caregivers, healthcare providers, and policymakers.

They include the following:

(1) The effectiveness, efficiency, and equity of cancer care interventions; (2) health technology assessments with a focus on cancer; (3) research on cancer care outcomes; (4) the use of cancer care services; (5) quality of cancer care; (6) access to cancer care; (7) cancer care costs; and (8) patients and caregivers.

The articles included in this Special Issue will contribute to identifying both best practices as well as areas needing improvement within cancer healthcare. By addressing gaps and challenges, these contributions will support the goal of ensuring that all individuals receive optimal and suitable cancer care to enhance their health outcomes.

Dr. Francesco Giusti
Dr. Carmen Martos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher’s Notice

The Special Issue, together with its publications, has been shifted from Section Cancer Epidemiology and Prevention to Section Cancer Survivorship and Quality of Life on 10 December 2025. The publications remain available in the regular issues in which they were originally published. The Editorial Office confirms that these articles adhered to MDPI's standard editorial process (https://www.mdpi.com/editorial_process).

Keywords

cancer care
cancer care outcomes
cancer care services
cancer costs
treatment
health systems
quality
survival
indicators
health technology assessments

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Published Papers (7 papers)

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Research

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18 pages, 852 KB

Open AccessArticle

Design and Interim Recruitment Outcomes of a Multi-Modal, Multi-Level Patient Navigation Intervention for Lung Cancer Screening in the Southeast U.S.

by Marvella E. Ford, Louise Henderson, Alison Brenner, Vanessa B. Sheppard, Stephanie B. Wheeler, Tiffani Collins, Monique Williams, Rosuany Vélez Acevedo, Christopher Lyu, Chyanne Summers, Courtenay Scott, Aretha R. Polite-Powers, Sharvette J. Slaughter, Dana LaForte, Darin King, Amber S. McCoy, Jessica Zserai, Sherrick S. Hill, Melanie Slan, Steve Bradley-Bull, Neusolia Valmond, Angela M. Malek, Ellen Gomez, Megan R. Ellison and Robert A. Winn Show full author list Hide full author list

Cancers 2025, 17(22), 3633; https://doi.org/10.3390/cancers17223633 - 12 Nov 2025

Viewed by 385

Abstract

Background/Objectives: Lung cancer is the leading cause of cancer death in the United States (U.S.). Virginia, South Carolina, and North Carolina are among the U.S. states with extraordinarily high rates of lung cancer mortality, particularly among Black residents. The current lung cancer screening guidelines, revised in 2021, support screening for younger, non-Medicare age-eligible individuals who smoke. However, their health insurance, if any, may not cover their screening. This lack of access could create more disparities in lung cancer mortality rates. Methods: To address this concern, the Virginia Commonwealth University Massey Comprehensive Cancer Center, the Medical University of South Carolina Hollings Cancer Center, and the University of North Carolina Chapel Hill Lineberger Comprehensive Cancer Center secured a four-year Stand Up To Cancer^® (SU2C) grant titled “Southeastern Consortium for Lung Cancer Screening (SC3) Study” with a novel aim to test the effectiveness of a multimodal, multilevel, barrier-focused patient navigation intervention to promote lung cancer screening among Black patients from federally qualified health centers. Results: A total of 170/675 Black participants have been recruited to date. The majority of participants (n = 134; 78.82%) were aged 55–74 years. Most participants were unmarried (n = 100; 58.82%), more than half had a high school education/GED or less (n = 111; 65.29%), most currently smoked (n = 142; 83.53%), and more males than females participated (n = 107; 62.94% male). Their reported lung cancer screening barriers, addressed by the patient navigators, were cost concerns, insurance coverage issues, and recent medical history precluding screening. Conclusions with Relevance to Cancer Health Equity: This SC3 study includes a unique lung cancer screening cohort that is in direct contrast to the predominantly White cohort in the National Lung Screening Trial. The SU2C study has created a novel, community-engaged approach to lung cancer screening navigation that could become the gold standard in high-risk medically underserved populations. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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22 pages, 1013 KB

Open AccessArticle

“We Just Get Whispers Back”: Perspectives of Primary and Hospital Health Care Providers on Between-Service Communication for Aboriginal People with Cancer in the Northern Territory

by Emma V. Taylor, Amy Elson, Bronte Avishai, Philip Mayo, Christine Sanderson and Sandra C. Thompson

Cancers 2025, 17(19), 3155; https://doi.org/10.3390/cancers17193155 - 28 Sep 2025

Viewed by 706

Abstract

Background/Objectives: Cancer is a leading cause of death for Aboriginal and Torres Strait Islander people, with remoteness increasing the risk for poorer outcomes. Primary health care (PHC) clinics have an important role in cancer screening, diagnosis, and post-discharge cancer care, particularly in remote communities, so accurate, timely communication between hospitals, specialists and PHC clinics is vital. This paper analyses the perspectives of Northern Territory health care professionals on communication between PHC and hospital services related to providing care for Aboriginal people with cancer and recommends strategies for improving communication between services. Methods: A qualitative study was undertaken in which semi-structured interviews were conducted with fifty staff from 15 health services (8 regional, remote, and very remote PHC clinics; 3 hospitals; one cancer centre and 3 cancer support services) between 2016 and 2019. Transcripts were thematically analysed, with findings categorized into barriers and enablers to communication. Results: Deficiencies in communication impeded patient care and support. A major barrier was fragmented, inefficient information systems; IT systems across health services were unable to interface, resulting in delayed/missing patient information that impacted discharge and follow up. Other barriers included PHC staff with limited knowledge of cancer, high turnover of PHC staff and tertiary hospital staff with limited understanding of remote health care challenges. Individuals used workarounds to overcome system failures and made substantial efforts around individual patients to improve communication. Specific roles and the use of telehealth between services and centralised cancer care services supported better between-service communication. Conclusions: Communication between hospital services and remote PHC clinics is essential to care for Aboriginal cancer patients; our research identified communication as inadequate in terms of consistency and timeliness. Commitment to more timely communication, health care IT systems that facilitate sharing information, designated staff in PHC clinics to support patients with cancer, dedicated Aboriginal cancer roles and additional resourcing to coordinate telehealth appointments could improve communication and sharing of patient information between services. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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13 pages, 1895 KB

Open AccessArticle

Reasons for and Congruence Between Preferred and Actual Place of Death Among Cancer Patients Receiving End-of-Life Care: A Cross-Cultural Multicenter Prospective Cohort Study in East Asia

by Chiu-Hsien Yang, Chien-Yi Wu, Shao-Yi Cheng, Masanori Mori, Sang-Yeon Suh, Sun-Hyun Kim, Wen-Yuan Lin, Takashi Yamaguchi, Hsien-Liang Huang, Jun Hamano, Yusuke Hiratsuka, Satoru Tsuneto, Tatsuya Morita, Ping-Jen Chen and on behalf of the EASED Investigators

Cancers 2025, 17(13), 2062; https://doi.org/10.3390/cancers17132062 - 20 Jun 2025

Viewed by 2027

Abstract

Background/Objectives: The place where a person dies serves as an indicator of end-of-life care quality. This study aims to identify the congruence of place of death (POD) and the reasons behind decision-making among terminally ill cancer patients in East Asia. Methods: We conducted a prospective multicenter cohort study in palliative care units in Japan, Korea, and Taiwan. Data were collected by the responsible physicians during routine clinical practice. Sankey diagrams were applied to present changes in reasons for POD incongruence. Results: A total of 2638 participants from 37 palliative care units in the three countries were enrolled, and most of them died at PCUs (Japan: 95.7%, Korea: 94%, Taiwan: 82%, p < 0.05). The congruence rate of the preferred and actual POD among PCU inpatients ranged from 70% to 80%. Availability of end-of-life care is the most common reason for preferred and eventual PCU death (78.6%, 72.2%, and 52.1%, respectively, p < 0.05). However, 13–22% of patients admitted to PCUs still preferred to die at home, for which traditional culture (20.2%, 40.8%, and 82%, respectively, p < 0.05) or family influence (44.4%, 38.8%, and 51.7%, respectively, p > 0.05) are the main reasons. Cultural and environmental factors, such as influences from family members’ preferences in the three countries or the ownership of housing/housing settings in Japan, are the main challenges in achieving POD congruence. Conclusions: Culturally inclusive strategies in clinical practice and policy implementation for identifying the preferred POD, enhancing communication among stakeholders, and facilitating transitional support may improve the quality of goal-concordant care. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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23 pages, 4520 KB

Open AccessArticle

An Evaluation of Rare Cancer Policies in Europe: A Survey Among Healthcare Providers

by Kostadin Kostadinov, Georgi Iskrov, Nina Musurlieva and Rumen Stefanov

Cancers 2025, 17(2), 164; https://doi.org/10.3390/cancers17020164 - 7 Jan 2025

Cited by 4 | Viewed by 2440

Abstract

Rare cancers, defined as those with an annual incidence of fewer than six cases per 100,000 individuals, are associated with significant health inequalities. This study aimed to assess the knowledge, attitudes, and perceptions of healthcare providers with expertise in rare cancers regarding the effectiveness of enacted or planned rare cancer policies across Europe. Between 25 March 2023 and 5 March 2024, we conducted an online survey targeting 738 healthcare providers affiliated with the European Reference Networks and the Organization of European Cancer Institutes, yielding 92 complete responses from 28 European countries (response rate: 12.5%). While a significant portion of respondents were unaware of their country’s legal definitions for rare cancers, 67.4% acknowledged that national cancer plans prioritized rare cancers. These plans received the highest ratings for their evidence-based interventions and monitoring efforts. The integration of rare cancer policies into broader oncology frameworks was the preferred policy model. National cancer registries were highly rated for confidentiality and validity but scored the lowest for cost-effectiveness. Government funding was deemed crucial for cancer screening programs. The disease burden and unmet health needs primarily influenced reimbursement decisions in the field of rare cancers. Respondents rated palliative care as more effective in adults with rare cancers compared to in children, particularly regarding symptom management. We confirmed significant variability in rare cancer policy evaluations across Europe, the necessity for a common EU-level definition for rare cancers, and a shift in reimbursement and policy framework models, highlighting the importance of policy integration and enhanced collaboration. However, given the limitations of the study, such as small sample size and possible unstudied confounding factors, we should interpret our findings with caution. A systematic policy review and multistakeholder assessment in the future could complement our results. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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21 pages, 1586 KB

Open AccessArticle

Factors Associated with Supportive Care Needs Among Palestinian Women with Breast Cancer in the West Bank: A Cross-Sectional Study

by Ibtisam Titi and Nuha El Sharif

Cancers 2024, 16(21), 3663; https://doi.org/10.3390/cancers16213663 - 30 Oct 2024

Cited by 4 | Viewed by 2666

Abstract

Background: Breast cancer (BC) is the most common cancer among women in Palestine, where the need for supportive care frequently goes unmet. Therefore, this study aims to assess the supportive care services provided at the governmental hospitals in the southern area of the West Bank and to determine the factors associated with the unmet needs of these services. Methods: A cross-sectional study was conducted on 362 women with BC. Data were collected using a face-to-face questionnaire that included the Supportive Care Needs Survey (SCNS-SF34), patients’ sociodemographic, economic, and clinical characteristics, as well as familial history of cancer and social support. Results: The study revealed that 61% of participants had unmet supportive care needs, with health system information, physical support, and psychological support being the most unmet needs. Factors contributing to unmet needs included age, marital status, familial support, and a family history of cancer. Chemotherapy and surgery increased the probability of physical care needs by fivefold, while hormone therapy reduced the probability of psychological needs (AOR = 0.36, p < 0.001) and patient care and support needs (AOR = 0.49, p = 0.01). Additionally, radiotherapy reduced sexual care needs by 58% and biological therapy by 60%. Conclusions: There is an urgent need for enhanced supportive care services for BC patients in the West Bank, especially regarding health system information, physical care, and psychological support. Addressing these needs through targeted interventions could significantly improve patients’ quality of life. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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19 pages, 4859 KB

Open AccessArticle

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

by Kostadin Kostadinov, Ivelina Popova-Sotirova, Yuliyana Marinova, Nina Musurlieva, Georgi Iskrov and Rumen Stefanov

Cancers 2024, 16(8), 1489; https://doi.org/10.3390/cancers16081489 - 12 Apr 2024

Cited by 5 | Viewed by 3201

Abstract

Rare cancers are defined by an annual incidence of fewer than 6 per 100,000. Bearing similarities to rare diseases, they are associated with substantial health inequalities due to diagnostic complexity and delayed access to innovative therapies. This situation is further aggravated in Southeastern European countries like Bulgaria, where limited public resources and expertise underscore the need for additional policy and translational research on rare cancers. This study aimed to explore the availability and access to orphan drugs for rare cancers in Bulgaria for the period of 2020–2023. We cross-compared data from both the European Union and national public sources to evaluate the number of available and accessible orphan drugs for rare cancers, the delay from market authorization to reimbursement, the dynamics of public expenditures, and regional disparities in access across the country. We juxtaposed the main characteristics of oncological and non-oncological orphan drugs as well. Only 15 out of 50 oncological orphan drugs that were authorized by the European Medicine Agency were accessible for rare cancer patients in Bulgaria. The median delay between market authorization and inclusion in the Bulgarian Positive Drug List was 760 days. The total expenditures for all orphan drugs for rare cancers amounted to EUR 74,353,493 from 2020 to 2023. The budgetary impact of this group rose from 0.24% to 3.77% of total public medicinal product expenditures for the study period. Rare cancer patients represent a vulnerable population that often faces limited to no access to treatment. We call for targeted European and national policies to address this major inequality. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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Review

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12 pages, 935 KB

Open AccessReview

Challenges and Opportunities in Breast Cancer Care in Low-Resourced Countries, Jordan as An Example

by Hikmat Abdel-Razeq and Asem Mansour

Cancers 2024, 16(9), 1751; https://doi.org/10.3390/cancers16091751 - 30 Apr 2024

Cited by 6 | Viewed by 4187

Abstract

Jordan is a relatively small country with a rapidly growing population and a challenged economy. Breast cancer is the most diagnosed cancer among women worldwide and also in Jordan. Though the age-standardized rate (ASR) of breast cancer incidence is still lower than that in Western societies, the number of newly diagnosed cases continues to increase, involving younger women, and new cases are usually detected at more advanced stages. Improvements in breast cancer care across the health care continuum, including early detection, prevention, treatment, and survivorship and palliative care, have become very visible, but may not match the magnitude of the problem. More organized, goal-oriented work is urgently needed to downstage the disease and improve awareness of, access to, and participation in early detection programs. The cost of recently introduced anti-cancer therapies poses a great challenge, but the impact of these therapies on treatment outcomes, including overall survival, is becoming very noticeable. Though the concept of a multidisciplinary approach to breast cancer treatment is often used at most health care facilities, its implementation in real practice varies significantly. The availability of breast reconstruction procedures, survivorship programs, germline genetic testing, counselling, and palliative care is improving, but these are not widely practiced. In this manuscript, we review the status of breast cancer in Jordan and highlight some of the existing challenges and opportunities. Full article

(This article belongs to the Special Issue Health Services Research in Cancer Care)

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