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Barriers in access to cancer treatment in Europe: a systematic review of the European Literature


 
 
 Within NCD`s, Cancer accounts for the 2nd most frequent cause after Cardiovascular diseases and in some European countries it´s the leading cause of premature deaths. One of the challenges within cancer therapy can be found in inequity in access to cancer treatment, because this causes worse health outcomes, which are attributable to the accessibility of health care and thus avoidable. The objective of the systematic review was to identify barriers in access to cancer treatment in Europe (inter-country) and within 6 European countries (intra-country): Spain, Germany, Switzerland, Finland, Bulgaria, UK.
 
 
 
 To obtain data scientific (PubMed, CINAHL, Embase) and grey literature were searched using keywords relating to inequity in access to cancer therapy in Europe. Collected Abstracts of published articles in English between 01/2013 and 05/2018 were reviewed independently. Identified barriers in access to cancer therapy were grouped into 2 categories: patient and health system/provider factors, followed by thematic analysis for each category.
 
 
 
 Out of 786 unique articles, 14 were included in the systematic review. The most frequent cited barriers within Europe were patient socioeconomic status (n = 7, 50%), age (n = 4, 28.6%) and reimbursement and availability of cancer medicine (n = 4, 28.6%).
 
 
 
 This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized. The amount of available studies with main focus on barriers in access to cancer therapy in Europe varies by equity stratifier, cancer site and type of treatment and seems to be very limited, showing a need for future investigations upon this topic with possibly uniform scales.
 
 
 
 This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized.
