背景:随着过去20年性别医学的发展,最近在肿瘤学领域,越来越多的证据表明癌症流行病学中的性别差异,以及与治疗相关的反应和毒性。在性别方法中,还必须考虑与性和性别少数群体(SGM)人口有关的关键问题。
方法:成立了一个由意大利医学肿瘤学协会(AIOM)批准的意见领袖工作组,目的是起草一份关于性别肿瘤学的共享文件。通过RAND/加州大学洛杉矶分校(UCLA)变体的“共识会议”方法,小组成员评估了部分来自科学文献的陈述,部分由专家自己[良好实践要点(GPPs)],关于以下主题:(I)医疗保健组织,(ii)治疗,(三)宿主因素,(四)癌症生物学,(五)沟通和社会干预。最后,支持每个特定主题,他们认为提出一些成功的案例研究是适当的。
结果:共有42篇文章符合纳入标准,从中提取了50条建议。小组参与者有机会从研究结果中未包括的研究中提出更多证据,从中提取了32个语句,并提出非来自GPPs等文献的建议,其中四个已经开发。在专家组评估了相关性之后,结果发现,81个建议得分>7,而3个得分在4和6.9之间,2个得分低于4。
结论:本共识和此后汇编的文件代表了对性别肿瘤学主题的现有科学证据的评估,并为科学研究和临床实践中患者护理提出标准标准标准,应考虑性别。
BACKGROUND: Following the development of gender medicine in the past 20 years, more recently in the field of oncology an increasing amount of evidence suggests gender differences in the epidemiology of cancers, as well as in the response and toxicity associated with therapies. In a gender approach, critical issues related to sexual and gender minority (SGM) populations must also be considered.
METHODS: A working group of opinion leaders approved by the Italian Association of Medical Oncology (AIOM) has been set up with the aim of drafting a shared document on gender oncology. Through the \'consensus conference\' method of the RAND/University of California Los Angeles (UCLA) variant, the members of the group evaluated statements partly from the scientific literature and partly produced by the experts themselves [good practice points (GPPs)], on the following topics: (i) Healthcare organisation, (ii) Therapy, (iii) Host factors, (iv) Cancer biology, and (v) Communication and social interventions. Finally, in support of each specific topic, they considered it appropriate to present some successful case studies.
RESULTS: A total of 42 articles met the inclusion criteria, from which 50 recommendations were extracted. Panel participants were given the opportunity to propose additional evidence from studies not included in the research results, from which 32 statements were extracted, and to make recommendations not derived from literature such as GPPs, four of which have been developed. After an evaluation of relevance by the panel, it was found that 81 recommendations scored >7, while 3 scored between 4 and 6.9, and 2 scored below 4.
CONCLUSIONS: This consensus and the document compiled thereafter represent an attempt to evaluate the available scientific evidence on the theme of gender oncology and to suggest standard criteria both for scientific research and for the care of patients in clinical practice that should take gender into account.