Abstract 1511P
Background
Developing countries make up four-fifths of the world’s population and more than 90% of the worldwide disease burden. The demographics of cancer in developing countries are different from those with a high or very high human development index (HDI).
Methods
This retrospective audit included all patients treated at the radiotherapy department in the last ten years at the largest academic university hospital in India’s most populous state, with a population of 200 million. The department functions as a clinical oncology unit where both radiotherapy and chemotherapy are practised. Patient records were retrieved from a prospectively maintained database, and their demographic and clinical details were recorded.
Results
Between 2011 and 2020, a total of 35194 patients were registered. Their characteristics are detailed in the table. The most common sites were head and neck (42%), gynaecological (18%), and gastrointestinal (15%). The median (interquartile range, IQR) age in years for head and neck, breast, gynaecological, and rectal cancers were as follows: 47 (38-58), 45 (38-53), 50 (40-58), and 40 (29-53), respectively. The mean distance travelled by a patient to the hospital was 110.6 kilometres (68.7 miles). Most patients had no formal education (64%). Only 8% patients had received higher education: undergraduate (6%) and postgraduate ( 2%). Approximately 70% of patients had an annual income of less than INR 35,000 (USD 500). Table: 1511P
1511P
| No | Percent | Age, yrs | ||
| Median | IQR | |||
| Head Neck | 14945 | 42 | 47 | 38-58 |
| Oral | 8109 | 23 | ||
| Oropharynx | 3197 | 9 | ||
| Hypopharynx | 646 | 2 | ||
| Larynx | 2109 | 6 | ||
| Nasopharynx | 162 | <1 | ||
| Paranasal Sinus | 311 | 1 | ||
| Salivary Gland | 224 | 1 | ||
| Other | 187 | 1 | ||
| Breast | 3107 | 9 | 45 | 38-53 |
| Lung | 1044 | 3 | 55 | 48-65 |
| Gynaecology | 6451 | 18 | 50 | 40-58 |
| Endometrium | 272 | 1 | ||
| Cervix | 5677 | 16 | ||
| Vulva | 73 | <1 | ||
| Vagina | 29 | <1 | ||
| Ovary | 400 | 1 | ||
| Gastrointestinal | 5118 | 15 | 50 | 42-58 |
| Oesophagus | 1184 | 3 | ||
| OG Junction, Stomach | 393 | 1 | ||
| Colon | 275 | 1 | ||
| Rectum | 976 | 3 | ||
| Anus | 226 | 1 | ||
| Pancreas | 199 | 1 | ||
| Biliary Tract | 1716 | 5 | ||
| Liver | 149 | <1 | ||
| Urology | 822 | 2 | 60 | 50-67 |
| Kidney | 63 | <1 | ||
| Ureter | 6 | <1 | ||
| Bladder | 349 | 1 | ||
| Prostate | 184 | 1 | ||
| Testis | 109 | <1 | ||
| Penis | 111 | <1 | ||
| CNS | 1190 | 3 | 32 | 14-50 |
| Haematology | 743 | 2 | 20 | 12-35 |
| Skin | 84 | <1 | 59 | 42-61 |
| STS | 226 | 1 | 50 | 34-58 |
| Bone sarcoma | 428 | 1 | 16 | 11-22 |
| Thyroid | 35 | <1 | 50 | 40-56 |
| Other | 1001 | 3 |
Conclusions
Oncology patients in developing countries represent a unique but large sub-group, often with a younger median age of presentation, low levels of formal education, distressed finances, and the need to travel significant distances to obtain specialised cancer care. Most guidelines originating from high HDI countries neither consider the financial nor logistical feasibility for these patients, and there is a profound unmet need to address the same.
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.