Refugee Cancer Care Burden Revealed

Planning is required to ensure the care of refugees with cancer

medwireNews: The costs and difficulties of caring for refugees with cancer have been highlighted in The Lancet Oncology.

Between 2010 and 2012, a quarter (25.6%) of the 1989 applications for treatment funding made to the United Nations High Commissioner for Refugees (UNHCR) Exceptional Care Committee (ECC) in Jordan were made for refugees with cancer. Most refugees were from Iraq or Syria and their healthcare costs were each expected to exceed US$ 2000.

Similarly, the ECC received requests for cancer treatment for 954 refugees in Syria between 2009 and 2011.

Around 60% of requests made to the ECC were for female patients, with breast cancer the most common diagnosis in both countries and colorectal cancer, soft-tissue cancer and haematological cancers also commonly reported.

Data available from Jordan show that 48.1% of requests to the ECC were approved, at an average request of US$ 11,540 in 2011 and US$ 5,151 in 2012. The average cost approved per request was US$ 4,626 and $3,501, respectively, with 73.1% and 66.3% of patients given the full amount.

Lead author Paul Spiegel, the UNHCR Chief Medical Expert, stated in a press release that, compared with short-term sub-Saharan African crises in the past, where healthcare has focused on malnutrition and infectious disease, the current refugee situations are “substantially longer and increasingly occur in middle-income countries where the levels of chronic diseases, including cancer, are higher.”

He continued: “Cancer diagnosis and care in humanitarian emergencies typifies a growing trend towards more costly chronic disease care, something that seems to have been overlooked, but is of increasing importance because the number of refugees is growing.”

The authors recommend improvements to healthcare systems to cope with refugees, and recognition of the need to balance their emergency, primary, secondary and tertiary care needs, including cancer screening and preventative advice.

Work to secure sustainable funding for cancer care for refugees, as well as initiate cancer registries and data management in these populations, is also essential, the researchers recommend.

“Ideally, these registries could be linked between countries in the region to allow migrants and forcibly displaced people the possibility of continuing treatment when feasible”, Paul Spiegel et al conclude.

Reference

Spiegel P, Khalifa A, Mateen F. Cancer in refugees in Jordan and Syria between 2009 and 2012: challenges and the way forward in humanitarian emergencies. Lancet Oncol 2014; 15(7): e290–297. doi:10.1016/S1470-2045(14)70067-1

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