297P - The utilization rate of radiotherapy and chemotherapy for cervical cancer in Indonesia: Optimal versus actual, how far the gap?

Background

Radiotherapy and chemotherapy, or a combination of both have a significant role in the management of cervical cancer. In order to reduce the burden of cervical cancer in a tangible way especially in Indonesia, the need for both modalities demand must be assessed. Considering this, it is necessary to discuss and determine the calculation of the optimal and actual Radiotherapy and Chemotherapy Utilization Rate (RUR and CUR), also the unmet need (gap) between the two rates for cervical cancer in Indonesia.

Methods

Descriptive study of cross-sectional design, total sampling method by taking secondary data from cancer registries and/or internal medical records of participating hospitals with radiotherapy centres in Indonesia in 2019. Data were then separated into hospital data (all cervical cancer cases in the hospital) and RT data (cases from radiotherapy department only).

Results

The total data from the 33 participating hospitals was 4937, divided into 3617 hospital data and 1320 RT data.

The average age of patients was 48-52 years (7-91 years). Patient domicile was mostly from Java Island. Stage III was the most common stage (39.4%). Cervical cancer management was dominated by radiotherapy alone and chemoradiation (28.5% and 27.4%).

Optimal rates can only be based on hospital data that have complete stage attributes.

The optimal, actual RUR and unmet need values were 97.2% (90.9-97.4%), 61.24%, and 36.7% (32.62-37.13%), respectively.

For CUR, the optimal, actual and unmet need values were 87.8% (81-88%), 40%, 54.5% (50.8-55%), respectively.

The actual RUR and CUR for combined data were 70.93% and 39.6%, respectively.

Conclusions

The optimal and actual values of RUR and CUR for cervical cancer in Indonesia still have a large gap, indicating more need for demand of both modalities.

Efforts are needed to increase the actualization of RUR and CUR closer to their optimal rate. Factors affecting RUR and CUR should be explored universally including the patient, clinician, and healthcare system aspects.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.