Cancer Deaths due to Lack of Universal Access to Radiotherapy in the Brazilian Public Health System

Mendez, Lucas C.; Moraes, Fábio Ynoe de; Fernandes, Gustavo dos Santos; Weltman, Eduardo

doi:10.1016/j.clon.2017.09.003

Cited by 49 publications

(43 citation statements)

References 27 publications

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“…25 In a recent report, it was estimated that 111,432 patients who required radiotherapy in 2016 did not receive this treatment, and that over 5,000 deaths would probably have been prevented in the cases of the most common cancer types if radiotherapy access were universal in the Brazilian Public Health System (SUS, in the Portuguese acronym). 28,29 There is room for improvement in three major areas when it comes to EC care and control in Brazil:…”

mentioning

confidence: 99%

Endometrial Cancer in Brazil: Preparing for the Rising Incidence

Paulino

Nogueira-Rodrigues

Goss

et al. 2018

Rev Bras Ginecol Obstet

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mentioning

confidence: 99%

Endometrial Cancer in Brazil: Preparing for the Rising Incidence

Paulino

Nogueira-Rodrigues

Goss

et al. 2018

Rev Bras Ginecol Obstet

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“…Approximately 111,000 of Brazilian patients (37%) who required RT did not receive it because of lack of access. Furthermore, in Brazil the highest proportional cause of death was cervix cancer ( Mendez et al, 2018 ).…”

Section: Radiation Therapy In Low- and Middle-income Countriesmentioning

confidence: 99%

Imaging and cancer of the cervix in low- and middle-income countries

Olpin

Chuang

Berek

et al. 2018

Gynecologic Oncology Reports

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Cervix cancer is the fourth most common cancer globally but the second most cancer in women in resource-limited countries. It has remained a clinically-staged neoplasm as per the International Federation of Gynecology and Obstetrics staging classification. As the imaging machines are becoming more available worldwide, the resource-stratified guidelines recommended the inclusion of imaging whenever possible to guide treatment planning. In this report, the utility of imaging in low- and middle-income countries for diagnosis and treatment of cancer of the cervix will be reviewed.

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“…Megavoltage machines are expensive and require highly specialized staff, and maintenance is also costly for developing countries. In spite of this, it has been shown that the patient lives and costs saved in providing timely and adequate radiation therapy will greatly outweigh what is expended in offering the service [ 15 , 16 ]. Yap and colleagues estimated that in LMIC, as much as 1.3 million people would derive a local control benefit by 2035 if the demand for radiotherapy was met.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy in the Caribbean: a spotlight on the human resource and equipment challenges among CARICOM nations

Alleyne-Mike¹,

Sylvester²,

Henderson-Suite³

et al. 2020

Hum Resour Health

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Background There is limited data on access to radiotherapy services for CARICOM nations. Methods This was a descriptive mixed-methods observational study which used data collected via survey from staff working in Radiation Oncology in 14 CARICOM countries. Benchmark recommendations from the International Atomic Energy Agency were compared to existing numbers. The Directory of Radiotherapy Centers, World Bank, and Global Cancer Observatory databases were all accessed to provide information on radiotherapy machines in the region, population statistics, and cancer incidence data respectively. Both population and cancer incidence-based analyses were undertaken to facilitate an exhaustive review. Results Radiotherapy machines were present in only 50% of the countries. Brachytherapy services were performed in only six countries (42.9%). There were a total of 15 external beam machines, 22 radiation oncologists, 22 medical physicists, and 60 radiation therapists across all nations. Utilizing patient-based data, the requirement for machines, radiation oncologists, medical physicists, and radiation therapists was 40, 66, 44, and 106, respectively. Only four (28.6%) countries had sufficient radiation oncologists. Five (35.7%) countries had enough medical physicists and radiation therapists. Utilizing population-based data, the necessary number of machines, radiation oncologists, and medical physicists was 105, 186, and 96 respectively. Only one county (7.1%) had an adequate number of radiation oncologists. The number of medical physicists was sufficient in just three countries (21.4%). There were no International Atomic Energy Agency population guidelines for assessing radiation therapists. A lower economic index was associated with a larger patient/population to machine ratio. Consequentially, Haiti had the most significant challenge with staffing and equipment requirements, when compared to all other countries, regardless of the evaluative criteria. Depending on the mode of assessment, Haiti’s individual needs accounted for 37.5% (patient-based) to 59.0% (population-based) of required machines, 40.1% (patient-based) to 59.7% (population-based) of needed radiation oncologists, 38.6% (patient-based) to 58.3% (population-based) of medical physicists, and 42.5% (patient-based) of radiation therapists. Conclusion There are severe deficiencies in radiotherapy services among CARICOM nations. Regardless of the method of comparative analysis, the current allocation of equipment and staffing scarcely meets 50% of regional requirements.

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Cancer Deaths due to Lack of Universal Access to Radiotherapy in the Brazilian Public Health System

Cited by 49 publications

References 27 publications

Endometrial Cancer in Brazil: Preparing for the Rising Incidence

Endometrial Cancer in Brazil: Preparing for the Rising Incidence

Imaging and cancer of the cervix in low- and middle-income countries

Radiotherapy in the Caribbean: a spotlight on the human resource and equipment challenges among CARICOM nations

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