ESTRO meets Asia 2024 - Abstract Book

S198

Interdisciplinary – Health economics & health services research

ESTRO meets Asia 2024

Vito F. Jayalie 1,2 , Gregorius B. Prajogi 1 , Tiara B.M. Permata 1 , Handoko Handoko 1 , Soehartati A. Gondhowiardjo 1

1 Department of Radiation Oncology, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. 2 Department of Radiation Oncology, Murni Teguh Memorial Hospital, Medan, Indonesia

Purpose/Objective:

To compare the optimal and actual radiotherapy utilization rate (RUR) of colon and rectal cancer in Indonesia

Material/Methods:

This was a cross-sectional study on cancer registry/medical records of hospitals with radiotherapy (RT) equipment across Indonesia. This research was part of the RCARO-IAEA project. We collected all colon and rectal cancer data (2019) to estimate and calculate RUR. Further sensitivity analyses were made to calculate the estimated RUR using GLOBOCAN and Indonesian Radiation Oncology Society (IROS) data.

Results:

Out of 34 hospitals, 1,211 and 2,119 colon and rectal cancer patients' data were collected and analyzed after further data duplication and double filtering. Most of the patients were male, 55-64 years old, and originated from North Sumatra, Central Java, and Jakarta. Regarding the staging, most patients came with locally advanced and advanced stages. Further calculation on optimal RUR (oRUR) showed that 3.3% (3-3.7%) and 41% (28-66%) of colon and rectal cancer patients needed RT. Although the actual RUR (aRUR) of colon cancer is higher than oRUR at 5.3%, the aRUR of rectal cancer is only 19.5%. Thus, the percentage of unmet needs for rectal cancer in Indonesia was 52.4% (30.4-70.5%). Nevertheless, the percentage of unmet needs will be more expansive if we extrapolate the data into a bigger perspective using sensitivity analysis. From population data (GLOBOCAN and IROS), the RUR for colon cancer ranges from 0.5 to 3.8%, while the RUR for rectal cancer is 4.4 to 20.6%. The percentage of unmet needs ranged from -76.7 to 86.5% and 2.2 to 94.2% for colon and rectal cancer, respectively.

Conclusion:

There is a difference between aRUR and oRUR of colon and rectal cancer in Indonesia based on the survey (hospital data). Colon cancer seems to have no gap, but rectal cancer still has a considerable gap. However, looking into the broader setting of the Indonesian population, gaps in RUR are still unavoidable. The variety in the percentage of unmet needs between centers may be affected by patient, clinical, and administrative/ bureaucracy related factors. Further study is required to understand better the factors affecting RUR in each center across Indonesia.

Keywords: RT utilization rate, colorectal cancer, Indonesia

References:

1. Yap ML, Hanna TP, Shafiq J, Ferlay J, Bray F, Delaney GP, et al. The benefits of providing external beam radiotherapy in low- and middle-income countries. Clin Oncol. 2017;29(2):72–83

2. Atun R, Jaffray DA, Barton MB, Bray F, Baumann M, Vikram B, et al. Expanding global access to radiotherapy. Lancet Oncol. 2015;16(10):1153–86.