Geographic Distribution of Cancer Care Providers in the Philippines

Abstract

PURPOSE In the Philippines, a lower middle-income country in Southeast Asia, 6 of 10 Filipinos die without seeing a doctor. To ensure universal access to cancer care, providers must be equitably distributed. Therefore, we evaluated the distribution of oncologists across all 17 regions in the Philippines. METHODS We gathered data from the official websites of national medical societies on their members' regional area of practice: Philippine Society of Medical Oncology, Philippine Radiation Oncology Society, Surgical Oncology Society of the Philippines, Society of Gynecologic Oncologists of the Philippines, and Philippine Society of Hospice and Palliative Medicine. We compared this with the regional census to determine the number of board-certified oncologists per 100,000 Filipinos. RESULTS For a population of almost 110 million, the Philippines has a total of 348 medical oncologists, 164 surgical oncologists, 99 radiation oncologists, 142 gynecologic oncologists, and 35 hospice and palliative medicine (HPM) specialists. This translates to 0.32 medical oncologists, 0.15 surgical oncologists, 0.09 radiation oncologists, 0.13 gynecologic oncologists, and 0.03 HPM specialists for every 100,000 Filipinos. The number of oncologists is highest in the National Capital Region in Luzon and lowest in the Bangsamoro Autonomous Region in Muslim Mindanao. All regions have at least one medical and gynecologic oncologist. Two regions (12%) have no surgical oncologists, five regions (29%) have no radiation oncologists, and eight regions (47%) have no HPM specialists. CONCLUSION Efforts are needed to increase the number of oncologists and improve equity in their distribution to ensure universal access to cancer care in the Philippines.

Cancer disparities in Southeast Asia: intersectionality and a call to action

“…From the Philippine and Indonesian archipelagos to the hilly and mountainous Laos PDR and Vietnam, healthcare resources, cancer treatment centers, and cancer registry data are often concentrated in large, urbanized cities, with far less access in remote and/or rural areas. 6 In 2017, the 146 cities among 81 provinces of the Philippines shared only 40 linear accelerators, 22 of which were found in metropolitan Manila, with the rest in a small number of major cities. 7 Furthermore, the only established population-based cancer registries that serve the Philippines also only cover a small number of areas, leaving gaps of knowledge concerning other smaller cities, provinces, and regions in the country.…”

“…This pattern reflects the broader tendency of already scarce health services to gravitate toward urban and affluent areas in mixed public-private health systems, as are prevalent in Southeast Asia. 1 , 6 , 7 Additionally, for many populations in the region, inadequate Internet connectivity and low availability of mobile healthcare delivery services hamper efforts to deliver quality services to the population in rural and remote areas. Many patients who need to traverse bodies of water or mountain ranges to access cancer care are unlikely to access adequate cancer care, if at all.…”

Palliative and Supportive Care in the Philippines: Systems, Barriers, and Steps Forward

“…8 In the public sector, national and local government-run facilities, mainly financed through a tax-based budgeting system, deliver health services to most Filipinos; however, it remains underfunded, understaffed, and resource-poor. 9,10 On the other hand, in the well-resourced private sector, which consists of for-profit and non-profit providers, health services are paid for through user fees at the point of service. The private sector, augmenting existing public sector inadequacies, has expanded considerably, with no effective mechanisms to regulate private providers.…”

“…Importantly, there are only 40 hospice and palliative medicine specialists and 272 individual service providers serving a population of 110 million Filipinos. 10,14 This may reflect a lack of opportunities for training in palliative medicine, as currently, only six local institutions are accredited to offer specialty training in the field.…”

To Chemo or Not to Chemo… That Is the Question

“…Unlike first-world countries, cancer care in developing countries is unique because more often than not, access to the most basic diagnostic tests and treatment facilities is limited. 1 , 2 Long and relatively expensive travels, the struggle of ensuring that the family has food to eat because of the missed opportunity to receive their daily wage, and the concentration of subspecialists in the major cities are some of the several barriers that need to be hurdled before being able to receive proper treatment from an oncologist in the Philippines. Thus, almost all types of cancers tend to be more extensive with an advanced stage at initial consult, subsequently compounding the burden of treatment.…”