Current and projected gaps in the availability of radiotherapy in the Asia-Pacific region: a country income-group analysis

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dc.authoridAbu Awwad, Dania/0000-0003-4327-0724
dc.authoridPineda, Jaffar/0000-0002-2420-3799
dc.contributor.authorAbu Awwad, Dania
dc.contributor.authorShafiq, Jesmin
dc.contributor.authorDelaney, Geoffrey Paul
dc.contributor.authorAnacak, Yavuz
dc.contributor.authorBray, Freddie
dc.contributor.authorFlores, Jerickson Abbie
dc.contributor.authorGondhowiardjo, Soehartati
dc.date.accessioned2024-08-31T07:46:44Z
dc.date.available2024-08-31T07:46:44Z
dc.date.issued2024
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground Cancer incidence and mortality is increasing rapidly worldwide, with a higher cancer burden observed in the Asia-Pacific region than in other regions. To date, evidence-based modelling of radiotherapy demand has been based on stage data from high-income countries (HIC) that do not account for the later stage at presentation seen in many low-income and middle-income countries (LMICs). We aimed to estimate the current and projected demand and supply in megavoltage radiotherapy machines in the Asia-Pacific region, using a national income-group adjusted model. Methods Novel LMIC radiotherapy demand and outcome models were created by adjusting previously developed models that used HIC cancer staging data. These models were applied to the cancer case mix (ie, the incidence of each different cancer) in each LMIC in the Asia-Pacific region to estimate the current and projected optimal radiotherapy utilisation rate (ie, the proportion of cancer cases that would require radiotherapy on the basis of guideline recommendations), and to estimate the number of megavoltage machines needed in each country to meet this demand. Information on the number of megavoltage machines available in each country was retrieved from the Directory of Radiotherapy Centres. Gaps were determined by comparing the projected number of megavoltage machines needed with the number of machines available in each region. Megavoltage machine numbers, local control, and overall survival benefits were compared with previous data from 2012 and projected data for 2040. Findings 57 countries within the Asia-Pacific region were included in the analysis with 9.48 million new cases of cancer in 2020, an increase of 2.66 million from 2012. Local control was 7.42% and overall survival was 3.05%. Across the Asia-Pacific overall, the current optimal radiotherapy utilisation rate is 49.10%, which means that 4.66 million people will need radiotherapy in 2020, an increase of 1.38 million (42%) from 2012. The number of megavoltage machines increased by 1261 (31%) between 2012 and 2020, but the demand for these machines increased by 3584 (42%). The Asia-Pacific region only has 43.9% of the megavoltage machines needed to meet demand, ranging from 9.9-40.5% in LMICs compared with 67.9% in HICs. 12 000 additional megavoltage machines will be needed to meet the projected demand for 2040. Interpretation The difference between supply and demand with regard to megavoltage machine availability has continued to widen in LMICs over the past decade and is projected to worsen by 2040. The data from this study can be used to provide evidence for the need to incorporate radiotherapy in national cancer control plans and to inform governments and policy makers within the Asia-Pacific region regarding the urgent need for investment in this sector. Copyright (c) 2024 Elsevier Ltd. All rights reserved.en_US
dc.description.sponsorshipRegional Cooperative Agreement Regional Office as part of the Regional Cooperative Agreement Research Project [RCARP03]; National Health and Medical Research Council Investigator Grant [APP 2018108]en_US
dc.description.sponsorshipThis work received funding support from the Regional Cooperative Agreement Regional Office as part of the Regional Cooperative Agreement Research Project, RCARP03. MLY is funded by a National Health and Medical Research Council Investigator Grant (APP 2018108).en_US
dc.identifier.endpage234en_US
dc.identifier.issn1470-2045
dc.identifier.issn1474-5488
dc.identifier.issue2en_US
dc.identifier.pmid38301690en_US
dc.identifier.scopus2-s2.0-85183508372en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage225en_US
dc.identifier.urihttps://hdl.handle.net/11454/104191
dc.identifier.volume25en_US
dc.identifier.wosWOS:001187011300001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofLancet Oncologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240831_Uen_US
dc.subjectAccessen_US
dc.titleCurrent and projected gaps in the availability of radiotherapy in the Asia-Pacific region: a country income-group analysisen_US
dc.typeArticleen_US

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