Radiotherapy resources in Africa: an International Atomic Energy Agency update and analysis of projected needs

Elmore, Shekinah N.C.; Polo, Alfredo; Bourque, Jean‐Marc; Pynda, Yaroslav; Merwe, D. van der; Grover, Surbhi; Hopkins, Kirsten; Zubizarreta, Eduardo; Abdel‐Wahab, May

doi:10.1016/s1470-2045(21)00351-x

Cited by 65 publications

(61 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As per a recent report, as of March 2020, only 21 (39%) out of 54 countries in Africa have access to brachytherapy. 8 A global estimate of the number of computed tomography (CT) simulators and treatment planning systems is challenging to garner as no formal data exist for most of the continents. Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an integral part of HERO-the ESTRO Health Economics in Radiation Oncology project.…”

Section: Where Do We Stand?mentioning

confidence: 99%

See 1 more Smart Citation

Access to Radiation Therapy: From Local to Global and Equality to Equity

Laskar

Sinha

Krishnatry

et al. 2022

JCO Global Oncology

View full text Add to dashboard Cite

The discipline of radiation oncology is the most resource-intensive component of comprehensive cancer care because of significant initial investments required for machines, the requirement of dedicated construction, a multifaceted workforce, and recurring maintenance costs. This review focuses on the challenges associated with accessible and affordable radiation therapy (RT) across the globe and the possible solutions to improve the current scenario. Most common cancers globally, including breast, prostate, head and neck, and cervical cancers, have a RT utilization rate of > 50%. The estimated annual incidence of cancer is 19,292,789 for 2020, with > 70% occurring in low-income countries and low-middle–income countries. There are approximately 14,000 teletherapy machines globally. However, the distribution of these machines is distinctly nonuniform, with low-income countries and low-middle–income countries having access to < 10% of the global teletherapy machines. The Directory of Radiotherapy Centres enlists 3,318 brachytherapy facilities. Most countries with a high incidence of cervical cancer have a deficit in brachytherapy facilities, although formal estimates for the same are not available. The deficit in simulators, radiation oncologists, and medical physicists is even more challenging to quantify; however, the inequitable distribution is indisputable. Measures to ensure equitable access to RT include identifying problems specific to region/country, adopting indigenous technology, encouraging public-private partnership, relaxing custom duties on RT equipment, global/cross-country collaboration, and quality human resources training. Innovative research focusing on the most prevalent cancers aiming to make RT utilization more cost-effective while maintaining efficacy will further bridge the gap.

show abstract

Section: Where Do We Stand?mentioning

confidence: 99%

“…As per a recent report, as of March 2020, only 21 (39%) out of 54 countries in Africa have access to brachytherapy. 8 …”

Section: Where Do We Stand?mentioning

confidence: 99%

Access to Radiation Therapy: From Local to Global and Equality to Equity

Laskar

Sinha

Krishnatry

et al. 2022

JCO Global Oncology

View full text Add to dashboard Cite

show abstract

“…A recent policy brief reports only one additional country in sub-Saharan Africa has gained brachytherapy access and 33 countries remain without this service. Therefore, even if there has been a 45% gain in external beam radiotherapy machine installation, cervical cancer outcomes will remain poor in most of sub-Saharan Africa 21…”

Section: Availability and Maintenance Of Equipmentmentioning

confidence: 99%

“…Therefore, even if there has been a 45% gain in external beam radiotherapy machine installation, cervical cancer outcomes will remain poor in most of sub-Saharan Africa. 21…”

Section: Reviewmentioning

confidence: 99%

Gynecological radiation oncology in sub-Saharan Africa: status, problems and considerations for the future

Lombe

M'ule

Msadabwe³

et al. 2022

International Journal of Gynecological Cancer

View full text Add to dashboard Cite

Gynecological malignancies in Africa form a significant part of the burden of disease. The high prevalence of HIV in some countries creates a heightened risk for development of human papilloma virus related cancers such as cervical, vulval and vaginal cancers. Radiotherapy is an important modality of treatment for cancer and in Africa compensates for the lack of adequate surgical services for a large proportion of cancers as well as being a cornerstone of treatment for locally advanced cancers and palliation. In this review we look at the status of radiotherapy services in sub-Saharan Africa and critical factors that influence its delivery with a focus on gynecological malignancies. This unveils that radiotherapy for gynecological cancers in sub-Saharan Africa is a significant example of the need for a holistic development approach across different sectors of the economy and different disciplines of medicine. The complexity of its management continues to expose the underdevelopment of health and financial systems and the lack of universal health coverage and social systems as we continue to see unnecessary morbidity and mortality due to the lack of organization. More systematic and scientifically robust investigations tailored to the various sub-Saharan Africa countries need to be conducted to elicit disruptive local solutions to the status quo.

show abstract

“… 1 Recent estimates of radiotherapy availability in Africa report that current capacity is only able to meet 30% of the estimated need. 11 Ghana, an LMIC in Africa, has demonstrated strong leadership and high-level support to improve the availability of radiotherapy. 12 However, the shortfall in radiotherapy resources in Ghana and the accessibility of these resources to the Ghanaian population across the country are unknown.…”

Section: Introductionmentioning

confidence: 99%

Geographic Accessibility and Availability of Radiotherapy in Ghana

et al. 2022

Self Cite

View full text Add to dashboard Cite

ImportanceRadiotherapy is critical for comprehensive cancer care, but there are large gaps in access. Within Ghana, data on radiotherapy availability and on the relationship between distance and access are unknown.ObjectivesTo estimate the gaps in radiotherapy machine availability in Ghana and to describe the association between distance and access to care.Design, Setting, and ParticipantsThis is a cross-sectional, population-based study of radiotherapy delivery in Ghana in 2020 and model-based analysis of radiotherapy demand and the radiotherapy utilization rate (RUR) using the Global Task Force on Radiotherapy for Cancer Control investment framework.ExposuresReceipt of radiotherapy and the number of radiotherapy courses delivered.Main Outcomes and MeasuresGeocoded location of patients receiving external beam radiotherapy (EBRT); median Euclidean distance from the district centroids to the nearest radiotherapy centers; proportion of population living within geographic buffer zones of 100, 150, and 200 km; additional capacity required for optimal utilization; and geographic accessibility after strategic location of a radiotherapy facility in an underserviced region.ResultsA total of 2883 patients underwent EBRT courses in 2020, with an actual RUR of 11%. Based on an optimal RUR of 48%, 11 524 patients had an indication for radiotherapy, indicating that only 23% of patients received treatment. An investment of 23 additional EBRT machines would be required to meet demand. The median Euclidean distance from the district centroids to the nearest radiotherapy facility was 110.6 km (range, 0.62-513.2 km). The proportion of the total population living within a radius of 100, 150 and 200 km of a radiotherapy facility was 47%, 61% and 70%, respectively. A new radiotherapy facility in the northern regional capital would reduce the median of Euclidean distance by 10% to 99.4 km (range, 0.62-267.7 km) and increase proportion of the total population living within a radius of 100, 150 and 200 km to 53%, 69% and 84%, respectively. The greatest benefit was seen in regions in the northern half of Ghana.Conclusions and RelevanceIn this cross-sectional study of geographic accessibility and availability of radiotherapy, Ghana had major national deficits of radiotherapy capacity, with significant geographic disparities among regions. Well-planned infrastructure scale-up that accounts for the population distribution could improve radiotherapy accessibility.

show abstract

Radiotherapy resources in Africa: an International Atomic Energy Agency update and analysis of projected needs

Cited by 65 publications

References 40 publications

Access to Radiation Therapy: From Local to Global and Equality to Equity

Access to Radiation Therapy: From Local to Global and Equality to Equity

Gynecological radiation oncology in sub-Saharan Africa: status, problems and considerations for the future

Geographic Accessibility and Availability of Radiotherapy in Ghana

Contact Info

Product

Resources

About