ESTRO 2024 - Abstract Book

S2815

Interdisciplinary - Health economics & health services research

ESTRO 2024

cancer staging adjusted RT utilisation models. The project has been conducted as part of the Regional Cooperative Agreement (RCARP03) for Research, Development and Training related to Nuclear Science and Technology for Asia and the Pacific.

Material/Methods:

The Collaboration for Cancer Outcomes Research and Evaluation (CCORE) RT optimal utilisation models were adjusted using LMIC and HIC cancer staging data. Each respective RT utilisation model was applied to each Asia Pacific country’s cancer case mix based on the country’s income level. Cancer data were obtained from GLOBOCAN, and the RT utilisation model was used to determine the number of patients that would be projected to need RT. From there, calculations were made on how many MVMs would be needed to service the number of patients that need RT. The number of MVMs available in each country was retrieved from the Directory of Radiotherapy Centres (DIRAC). Income classifications were obtained from the World Bank and grouped into high income, upper and lower middle-income, and low-income countries.

Results:

Currently, we estimated a deficit of 6800 MVMs in the Asia-Pacific, an increase of 52% from the previous decade. This means that approximately 2.8 million people, with evidence-based indications for RT, cannot receive RT due to a lack of machine availability. The deficit is expected to reach 10,000 MVMs by the end of the decade if no improvements are made to the number of machines installed. Compared to the previous decade, projected demand for MVM increased by 42% yet MVM supply increased by only 31%. This effect was the worst in upper middle-income countries, which had a 53% increase in the demand for MVM but an increase of 27% of the number of MVM machines. The most resource challenged are low-income countries which only have 10% of their projected MVM demand, resulting in an average of 4112 patients per MVM per year that need RT. Lower- and middle-income countries have a third of the number of MVM needed to meet projected demand while high-income countries have more than two thirds of the required demand. Overall, a third of all MVMs in the Asia-Pacific are located in high-income countries, despite only 15% of the total number of patients that require RT living there. The demand for RT is increasing at a higher rate than MVM machines are being acquired, further increasing the deficits in RT access for cancer treatment. Our previous estimates predicted a deficit of >7000 MVM worldwide, yet that is now the current deficit in the Asia-Pacific alone. Analysis of the time trend over the past decade has shown further widening of MVM gaps with no signs of improvement across income groups in the Asia-Pacific region. These deficits in machines and high demand for RT does not consider further challenges to access such as distance to cancer centres, long waiting lists, appropriate training of adequate staff numbers, and financial costs. Therefore, the number of patients that are unable to access RT is expected to be higher than predicted and accelerate. Prioritising RT in comprehensive cancer control planning is imperative and urgent action is required to help reduce the current and future cancer burden and to ensure that every patient, regardless of their location or income, can access the care they need. Conclusion: