433P - Variations in radiation oncology treatment access in Asia and its implications on cancer care

Background

An estimated 70-80% of malignancies need multimodal treatment, which includes surgery, radiation, and chemotherapy. Radiation oncology is particularly vulnerable to regional disparities in access to care due to the unique nature of its treatments.It is vital to define geographic and demographic access to radiotherapy in order to improve patient access to clinical care.This first of its kind study aimed at quantifying the available radiation oncology resources across all Asian counties.

Methods

The availability of Teletherapy and Brachytherapy resources of all Asian Countries was obtained from IAEA-DIRAC. The population o was estimated using World Bank Population Estimates. The incidence of cancers was obtained from Globocan Reports.Available number of treatment units were compared with that of the population, overall cancer incidence and five most common cancers among countries across Asia. Total EBRT treatment capacity was estimated by multiplying the number of units per country with 240 working days. Assuming that 50 patients would be treated per day, a proportional treatment space of 15% was estimated for Breast and lung cancers and, 10% each for stomach, cervical and oesophageal cancers. Therefore, feasible fractions were estimated as: number of EBRT units per country × 240 × (0.15 or 0.10) × 50. Number of excess or deficit fractions were calculated, and the total number of extra machines required was arrived at.

Results

Number of teletherapy units varied from 1 to 1825 across countries. Yemen had the least number of teletherapy units per million population (0.03) whereas Japan had the highest (8.66). Brunei had 1 teletherapy machine per 493 cancer cases whereas North Korea had 1 machine per 19218 cases. Qatar had 1 brachytherapy machine for 1482 cancer cases and Taiwan had 1 Brachytherapy machine for 55483 cancer cases.41 countries had a deficit in number of teletherapy machines with respect to breast cancer. Similarly, 33, 28, 32 and 18 countries had a deficit with respect to lung, stomach, cervical and oesophageal cancers respectively.

Conclusions

The study identified deficits of radiotherapy units in terms of geographic and demographic aspect across Asian countries and provides a roadmap for development of radiation oncology 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.