Lancet Oncology Commission calls for expanding global access to radiotherapy

The Commission found that up to 60 per cent of all cancer patients worldwide will need radiotherapy at some point in their treatment

Increasing access to radiotherapy worldwide through greater investment could save millions of lives, according to The Lancet Oncology Commission’s report presented at the 2015 European Cancer Congress in Vienna, Austria , and published in The Lancet Oncology. The Commission’s results were presented at the 2015 annual meeting of the American Society for Radiation Oncology (ASTRO).

The Commission found that up to 60 per cent of all cancer patients worldwide will need radiotherapy at some point in their treatment, but a lack of investment in radiotherapy services has severely limited access to radiotherapy treatments worldwide, especially in low-income and middle-income countries (LMIC).

LMIC have 80 per cent of the global cancer burden but only five per cent of the resources for cancer control, and in low-income countries, 90 per cent of the population lack access to radiotherapy. Even in high income countries the numbers of radiotherapy facilities, equipment, and trained staff are inadequate.

Radiotherapy is important for managing most cancers, such as breast, lung, prostate, head and neck, and cervical cancers, which account for more than two-fifths of cases worldwide. In their report, the Commission details how a persistent under-investment in radiotherapy globally has diminished access, and describes the substantial health and economic benefits of investing in radiotherapy.

With the number of new cancer cases expected to rise to 24.6 million by 2035, the Commission claims that increasing access to radiotherapy services in LMIC by scaling up radiotherapy capacity from current levels could lead to a saving of 27 million life years by 2035, over the lifetime of patients who receive this treatment.

In addition to saving human lives, providing full access to radiotherapy through investment could reduce the economic burden of cancer worldwide, which was $2 trillion in 2010. By 2035, full access to radiotherapy for all patients in LMIC could be achieved for as little as $97 billion, with economic benefits ranging from $278 billion to $365 billion over the next 20 years.

The Commission called for a long-term commitment to cancer care and treatment through the following actions:

1. 80 per cent of countries should have cancer plans that include radiotherapy by 2020.
2. By 2025, radiotherapy treatment capacity should be increased by 25 per cent from 2015 capacity.
3. Each LMIC should have at least once cancer center by 2020.
4. LMIC should train 7,500 radiation oncologists; 20,000 radiation technologists; and 6,000 medical physicists by 2025.
5. LMIC should invest $46 billion by 2025 to establish radiotherapy infrastructure and training.
6. 80 per cent of LMIC should include radiotherapy services as part of their universal health coverage by 2020.

“The Lancet Commission has done an impressive job of demonstrating how increasing access to life-saving radiotherapy treatment makes sense not only for the health and well-being of our world community but economically as well,” said Dow R Wilson, President and CEO, Varian Medical Systems.