David Jaffray

Expanding global access to radiotherapy

Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US

The anatomy of the iliolumbar vein: A CADAVER STUDY

26·6 billion in low-income countries,

Talectomy for club foot in arthrogryposis

62·6 billion in lower-middle-income countries, and

The Batchelor-Grice extra-articular subtalar arthrodesis

94·8 billion in upper-middle-income countries, which amounts to

Global Task Force on Radiotherapy for Cancer Control.

184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower:

Dwyer-Hartshill transpedicular fixation for spinal fusion

14·1 billion in low-income,

Correction of severe cervical kyphosis in ankylosing spondylitis by traction.

33·3 billion in lower-middle-income, and

Radiation therapy and the global health agenda.

49·4 billion in upper-middle-income countries-a total of

Global impact of radiotherapy in oncology: Saving one million lives by 2035

96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of

Global Access to Radiation Therapy for Cervical Cancer: The Cost of Inaction

278·1 billion in 2015-35 (