198P - Geographic and demographic access to brachytherapy in India, with a special emphasis on gynaecological cancers

Background

Geographic access to medical care varies for nearly every specialty in India. Brachytherapy (BT) is emblematic of several of these access difficulties since it necessitates specialized equipment, the capacity to maintain a radioactive source, and particular skill sets. To quantify the unmet infrastructure needs, we conducted this study to report the availability of brachytherapy treatment units in relation to state-level population, and gynaecologic cancer incidence in India.

Methods

The availability of BT resources at the state level in India was obtained from the IAEA database. The population of each state was estimated using data from the Government of India's census. Using National Cancer Registry program data, the number of cancer cases was approximated for each state and union territory. The total number of gynaecological cancers that required BT was determined. BT capacity was estimated at three procedures per unit per day for 240 days(Excluding holidays and weekends) as follows: number of BT units x 240 x 3. The disparity between available and needed infrastructure was used to compute the deficit in BT units. Number of BT facilities available in medical colleges across India were calculated. The BT infrastructure was also compared to those of other nations in terms of the number of BT units available per million people and for various malignancies.

Results

India has 1 brachytherapy unit every 42,93,031 population. With respect to state wise data, 21 states and union territories had deficits of brachytherapy units. The maximum deficit was seen in Uttar Pradesh. The maximum units per 10,000 cancer patients was noted in Delhi (7) and the least was noted in the North Eastern states (<1). In brachytherapy of gynaecological cancers a deficit ranging from 1-75 units were noted across the states. It was noted that only 104 out of the 613 medical colleges in India had BT facilities. India had 1 BT machine for every 4181 cancer patients when compared to USA ( 2956 patients), Germany (2754 patients) and Japan (4303 patients).

Conclusions

The study identified the deficits of BT facilities in India and provides a direction for the development of BT infrastructure.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Abhishek Krishna.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.