ESTRO 2025 - Abstract Book

S2273

Interdisciplinary – Health economics & health services research

ESTRO 2025

1029

Digital Poster Stage-Adjusted Forecasting of Radiotherapy Demand and Outcome Benefits Across Income Groups with Correlation to Cancer Plan Prioritisation Mengqi Zhou 1,2 , Mei Ling Yap 3,2,4 , Dania Abu Awwad 5 , Geoffrey Paul Delaney 3,6,7 , Vikneswary Batumalai 2 , Aba Scott 8 , Eduardo Zubizarreta 9 , Yavuz Anacak 10,11 , Soehartati Gondhowiardjo 12,13 , Mayang Permata 12,13 1 Department of Radiation Oncology, Chris O'Brien Lifehouse, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. 2 The George Institute for Global Health, University of New South Wales, Barangaroo, NSW, Australia. 3 Collaboration for Cancer Outcomes, Research and Evaluation, Liverpool Hospital, Ingham Institute, University of New South Wales, Liverpool, NSW, Australia. 4 Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, NSW, Australia. 5 Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. 6 South western Sydney clinical schoo, University of New South Wales, Sydney, NSW, Australia. 7 Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, Australia. 8 Department of Radiation Oncology, Dalhousie University, Nova Scotia, Canada. 9 Applied Radiation Biology and Radiotherapy Section, International Atomic Energy Agency, Vienna, Austria. 10 Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey. 11 Division of Human Health, International Atomic Energy Agency, Vienna, Austria. 12 Radiation Oncology Department, Dr. Cipto Mangunkusumo National General Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 13 Indonesian Radiation Oncology Society, Indonesian Radiation Oncology Society, Jakarta, Indonesia Purpose/Objective: Radiotherapy plays a key role in improving local control and survival, yet access remains limited, especially in low- and middle-income countries (LMICs). Current estimates of global demand overlook the variability in cancer stage at diagnosis across different country income levels, impacting radiotherapy needs and outcomes. This study aims to predict global radiotherapy demand by 2050 and the population-level outcome benefits if resources are optimal. It will evaluate the correlation between the prioritisation of radiotherapy in National Cancer Control Plans (NCCPs) with the current availability of radiotherapy megavoltage machines (MVMs) and income levels. Material/Methods: Data on global cancer distribution, excluding non-melanoma skin cancers, were extracted from GLOBOCAN 2022, including projections to 2050. Countries were categorised by income level per the 2023 World Bank classification. MVM data were extracted from the IAEA’s Directory of Radiotherapy Centres. The CCORE stage-adjusted Optimal radiotherapy utilisation (ORTU) model 1 was adapted to available cancer stage data from LMICs from geographical regions (Sub-Sahran Africa, Malaysia, Russia, Ecuador). The CCORE population-based local control and survival benefit models 2 from radiation therapy were also stage-adjusted. NCCP radiotherapy data from a 2023 International Cancer Control Partnership global review were analysed. Correlation between MVM availability and income levels and NCCP radiotherapy prioritisation was assessed. Results: Using the stage adjusted CCORE ORTU model, the optimal RTUs vary across geographic regions in LMICs. For example, the cervical cancer optimal RTU is 71% in high income countries, 80% for Latin American and Asian LMICs, 87% for Africa, and 73% for European LMICs. An analysis of 185 countries shows that there will be 9.3 million cases requiring radiotherapy in 2022, with a supply-demand gap of 11,076 MVMs (Table 1). By 2050, 14.6 million cases are projected to require radiotherapy. Optimising access would result in >900,000 people deriving a survival benefit and 2.1 million cases having a local control benefit from radiotherapy. Low-income countries are estimated to derive the highest population-based benefits in local control (11.54%) and survival (4.79%). Globally, 98 countries had NCCPs; countries with fewer MVMs per 1,000 patients and lower income levels were more likely to include more comprehensive radiotherapy strategies (Table 2).