Discrepancies in breast cancer management

Michał Seweryn; Tomasz Banaś; Joanna Streb; Rafał Matkowski; Wojciech Wysocki; Joanna Augustyńska; Justyna Kopel; Ola Kizińska

doi:10.5114/jhi.2021.107956

eISSN: 2450-5722
ISSN: 2450-5927

Journal of Health Inequalities

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1/2021
vol. 7

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abstract:

Original paper

Discrepancies in breast cancer management

Michał Seweryn

^{1, 2}

,

Tomasz Banaś

³

,

Joanna Streb

⁴

,

Rafał Matkowski

^{5, 6}

,

Wojciech Wysocki

^{7, 8}

,

Joanna Augustyńska

²

,

Justyna Kopel

²

,

Ola Kizińska

²

Associate of the Institute – European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
EconMed Europe, Kraków, Poland
Department of Gynaecology and Gynaecological Oncology, Chair of Gynaecology and Obstetrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
Chair of Clinical Oncology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
Wrocław Medical University, Wrocław, Poland
Lower Silesian Oncology Centre, Wrocław, Poland
Department of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Krakow, Poland
Chair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland

J Health Inequal 2021; 7 (1): 63–69

DOI: https://doi.org/10.5114/jhi.2021.107956

Online publish date: 2021/06/29

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Introduction
Breast cancer is one of the most frequently diagnosed neoplasms among women, and the number of cases is increasing every year. Although the incidence rate places Poland below the European Union average, the mortality rate shows that a problem with the diagnosis and treatment of breast cancer exists. We tried to answer whether the current path of a breast cancer patient in Poland is optimal, whether patients have access to all possible treatment options, and whether the treatment centre has a significant impact on the treatment method.

Material and methods
To achieve the study goals, we obtained data from the National Health Fund on the structure of procedures related to the treatment of breast cancer, and we conducted a survey in hospitals and performed individual in-depth interviews with experts.

Results
Among all hospitals in Poland, only 8% (47 hospitals) implement at least 4 of the basic profiles of breast cancer treatment: oncological surgery, clinical oncology, radiotherapy, and access to tailored therapies. Only 9 centres in Poland were accredited as a Breast Cancer Unit. Most hospitalizations related to the treatment of breast cancer are carried out in oncology hospitals (28.8%) and national hospitals (24.8%). However, nearly 27% of hospitalizations took place in units with no more than the 2nd-level of referentiality. The results of the survey and interviews with experts indicate that treatment of breast cancer patients, performed in centres with low reference levels, does not ensure an adequate level of treatment quality and coordination.

Conclusions
The right treatment path for a patient with breast cancer is a guarantee of long-term survival and high-quality treatment. Unfortunately, fragmentation of the oncological services in Poland means that there is still no oncological care system for patients with breast cancer that provides an equal level of care to patients regardless of the selected centre for treatment.

keywords:

healthcare disparities, organization and administration, health services accessibility, breast neoplasm therapy, treatment outcome

Journal published under the patronage of:

Discrepancies in breast cancer management

Michał Seweryn 1, 2 , Tomasz Banaś 3 , Joanna Streb 4 , Rafał Matkowski 5, 6 , Wojciech Wysocki 7, 8 , Joanna Augustyńska 2 , Justyna Kopel 2 , Ola Kizińska 2

healthcare disparities, organization and administration, health services accessibility, breast neoplasm therapy, treatment outcome

Michał Seweryn

^{1, 2}

,

Tomasz Banaś

³

,

Joanna Streb

⁴

,

Rafał Matkowski

^{5, 6}

,

Wojciech Wysocki

^{7, 8}

,

Joanna Augustyńska

²

,

Justyna Kopel

²

,

Ola Kizińska

²