T.P. Hanna

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

Estimating the demand for radiotherapy from the evidence: A review of changes from 2003 to 2012

26·6 billion in low-income countries,

A Comparison of Evidence-Based Estimates and Empirical Benchmarks of the Appropriate Rate of Use of Radiation Therapy in Ontario

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

The population benefit of radiotherapy for cervical cancer: Local control and survival estimates for optimally utilized radiotherapy and chemoradiation

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

Surface mold brachytherapy for nonmelanoma skin cancer: Canadian patterns of practice.

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

The global cancer epidemic: opportunities for Canada in low- and middle-income countries

14·1 billion in low-income,

Radiotherapeutic Management of Non–Small Cell Lung Cancer in the Minimal Resource Setting

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

Stroke After Radiation Therapy for Head and Neck Cancer: What Is the Risk?

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

A Population-based Model of Local Control and Survival Benefit of Radiotherapy for Lung Cancer

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

Estimating the Population Benefit of Radiotherapy: Using Demand Models to Estimate Achievable Cancer Outcomes

278·1 billion in 2015-35 (