title: Disparities in Retinoblastoma Presentation, Treatment, and Outcomes in Developed and Less-Developed Countries.
abstract: Retinoblastoma (RB) is the most common intraocular malignancy in children. In the past century, RB survival rates in developed countries (DCs) have improved from <5% to as high as 99%. In contrast, in less developed countries (LDCs) where the tumor burden is greatest, survival rates remain poor, with some countries reporting survival rates as low as 0-5%. In addition, there are disparities between DCs and LDCs in RB presentation, treatment modalities, and prognosis. These disparities are due to many underlying causes, including delays in diagnosis, access to medical care, patient and physician familiarity with the disease, availability and cost of treatment, and patient acceptance of enucleation. It is our belief that attempts to extend the improvements in prognosis achieved in DCs to various LDCs must be culturally sensitive and tailored to each country's specific challenges, and thus, a "one-size-fits-all" approach to improving patient outcomes in LDCs is unlikely to work well. We discuss several culturally sensitive approaches that have been successfully implemented in various LDCs, including those that make use of telemedicine and "twinning" with centers of excellence around the world.
authors.affiliation: a Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Gobind
authors.initials: G
authors.lastname: Singh
authors.affiliation: a Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA.|b Department of Radiation Oncology , Vanderbilt University Medical Center , Nashville , TN , USA.|c Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center , Nashville , TN , USA.|d Department of Cancer Biology , Vanderbilt University , Nashville , TN , USA.
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Daniels
mesh_terms: D019049:Developed Countries; D003906:Developing Countries; D054624:Health Status Disparities; D006801:Humans; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012175:Retinoblastoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
keywords: Health disparity; ocular oncology; retinoblastoma