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Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis

Manjit Dosanjh, Vesna Gershan, Eugenia C Wendling, Jamal S Khader, Taofeeq A Ige, Mimoza Ristova, Richard Hugtenburg Orcid Logo, Petya Georgieva, C Norman Coleman, David A Pistenmaa, Gohar H Hovhannisyan, Tatul Saghatelyan, Kamal Kazimov, Rovshan Rzayev, Gulam R Babayev, Mirzali M Aliyev, Eduard Gershkevitsh, Irina Khomeriki, Lily Petriashvili, Maia Topeshashvili, Raushan Zakirova, Aigerim Rakhimova, Natalya Karnakova, Aralbaev Rakhatbek, Narynbek Kazybaev, Oksana Bondareva, Kristaps Palskis, Gaļina Boka, Erika Korobeinikova, Linas Kudrevicius, Ion Apostol, Ludmila V Eftodiev, Alfreda Rosca, Galina Rusnac, Mukhabatsho Khikmatov, Sergii Luchkovskyi, Yuliia Severyn, Jamshid M Alimov, Munojat Ismailova, Suvsana M Talibova

The Lancet Oncology, Volume: 25, Issue: 11, Pages: 1487 - 1495

Swansea University Author: Richard Hugtenburg Orcid Logo

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DOI (Published version): 10.1016/s1470-2045(24)00452-2

Abstract

BackgroundOnly 10–40% of patients with cancer in low-income and middle-income countries were able to access curative or palliative radiotherapy in 2015. We aimed to assess the current status of diagnostic imaging and radiotherapy services in the Baltic countries, eastern Europe, central Asia, and th...

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Published in: The Lancet Oncology
ISSN: 1470-2045
Published: Elsevier BV 2024
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We aimed to assess the current status of diagnostic imaging and radiotherapy services in the Baltic countries, eastern Europe, central Asia, and the Caucasus by collecting and analysing local data.MethodsThis Access to Radiotherapy (ART) comprehensive analysis used data from 12 countries: the three Baltic countries (Estonia, Latvia, and Lithuania), two countries in eastern Europe (Moldova and Ukraine), four countries in central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan), and three countries in the Caucasus (Armenia, Azerbaijan, and Georgia), referred to here as the ART countries. We were not able to obtain engagement from Turkmenistan. The primary outcome was to update the extent of shortfalls in the availability of diagnostic imaging and radiotherapy technologies and radiotherapy human resources for patients with cancer in former Soviet Union countries. Following the methods of previous similar studies, we developed three questionnaires&#x2014;targeted towards radiation oncologists, regulatory authorities, and researchers&#x2014;requesting detailed information on the availability of these resources. Authors from participating countries sent two copies of the appropriate questionnaire to each of 107 identified institutions and coordinated data collection at the national level. Questionnaires were distributed in English and Russian and responses in both languages were accepted. Two virtual meetings held on May 30 and June 1, 2022, were followed by an in-person workshop held in Almaty, Kazakhstan, in September, 2022, attended by representatives from all participating countries, to discuss and further validate the data submitted up to this point. The data were collected on a dedicated web page, developed by the International Cancer Expert Corps, and were then extracted and analysed.FindingsData were collected between May 10 and Nov 30, 2022. 81 (76%) of the 107 institutions contacted, representing all 12 ART countries, submitted 167 completed questionnaires. The Baltic countries, which are defined as high-income countries, had more diagnostic imaging equipment and radiotherapy human resources (eg, Latvia [1&#xB7;74] and Lithuania [1&#xB7;47] have a much higher number of radiation oncologists per 100 000 population than the other ART countries, all of which had &lt;1 radiation oncologist per 100 000 population) and greater radiotherapy technological capacities (higher numbers of linear accelerators and, similar to Georgia, high total external beam radiotherapy capacity) than the other ART countries, as well as high cancer detection rates (Latvia 311 cases per 100&#x2009;000 population, Lithuania 292, and Estonia 288 vs, for example, 178 in Armenia, 144 in Ukraine, and 72 in Kazakhstan) and low cancer mortality-to-cancer incidence ratios (Estonia 0&#xB7;43, Latvia 0&#xB7;49, and Lithuania 0&#xB7;48; lower than all but Kazakhstan [0&#xB7;41]). The highest cancer mortality-to-cancer incidence ratios were reported by Moldova (0&#xB7;71) and Georgia (0&#xB7;74).InterpretationOur findings show that the number of cancer cases, availability of diagnostic imaging equipment, radiation oncologists and radiotherapy capacity, and cancer mortality-to-cancer incidence ratios all vary substantially across the countries studied, with the three high-income, well resourced Baltic countries performing better in all metrics than the included countries in eastern Europe, central Asia, and the Caucasus. These data highlight the challenges faced by many countries in this study, and might help to justify increased investment of financial, human, and technological resources, with the aim to improve cancer treatment outcomes.</abstract><type>Journal Article</type><journal>The Lancet Oncology</journal><volume>25</volume><journalNumber>11</journalNumber><paginationStart>1487</paginationStart><paginationEnd>1495</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1470-2045</issnPrint><issnElectronic/><keywords/><publishedDay>1</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-11-01</publishedDate><doi>10.1016/s1470-2045(24)00452-2</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Not Required</apcterm><funders/><projectreference/><lastEdited>2025-01-16T12:07:40.6188870</lastEdited><Created>2024-11-06T14:44:25.5260379</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medical Physics</level></path><authors><author><firstname>Manjit</firstname><surname>Dosanjh</surname><order>1</order></author><author><firstname>Vesna</firstname><surname>Gershan</surname><order>2</order></author><author><firstname>Eugenia C</firstname><surname>Wendling</surname><order>3</order></author><author><firstname>Jamal S</firstname><surname>Khader</surname><order>4</order></author><author><firstname>Taofeeq A</firstname><surname>Ige</surname><order>5</order></author><author><firstname>Mimoza</firstname><surname>Ristova</surname><order>6</order></author><author><firstname>Richard</firstname><surname>Hugtenburg</surname><orcid>0000-0003-0352-9607</orcid><order>7</order></author><author><firstname>Petya</firstname><surname>Georgieva</surname><order>8</order></author><author><firstname>C Norman</firstname><surname>Coleman</surname><order>9</order></author><author><firstname>David A</firstname><surname>Pistenmaa</surname><order>10</order></author><author><firstname>Gohar H</firstname><surname>Hovhannisyan</surname><order>11</order></author><author><firstname>Tatul</firstname><surname>Saghatelyan</surname><order>12</order></author><author><firstname>Kamal</firstname><surname>Kazimov</surname><order>13</order></author><author><firstname>Rovshan</firstname><surname>Rzayev</surname><order>14</order></author><author><firstname>Gulam R</firstname><surname>Babayev</surname><order>15</order></author><author><firstname>Mirzali M</firstname><surname>Aliyev</surname><order>16</order></author><author><firstname>Eduard</firstname><surname>Gershkevitsh</surname><order>17</order></author><author><firstname>Irina</firstname><surname>Khomeriki</surname><order>18</order></author><author><firstname>Lily</firstname><surname>Petriashvili</surname><order>19</order></author><author><firstname>Maia</firstname><surname>Topeshashvili</surname><order>20</order></author><author><firstname>Raushan</firstname><surname>Zakirova</surname><order>21</order></author><author><firstname>Aigerim</firstname><surname>Rakhimova</surname><order>22</order></author><author><firstname>Natalya</firstname><surname>Karnakova</surname><order>23</order></author><author><firstname>Aralbaev</firstname><surname>Rakhatbek</surname><order>24</order></author><author><firstname>Narynbek</firstname><surname>Kazybaev</surname><order>25</order></author><author><firstname>Oksana</firstname><surname>Bondareva</surname><order>26</order></author><author><firstname>Kristaps</firstname><surname>Palskis</surname><order>27</order></author><author><firstname>Ga&#x13C;ina</firstname><surname>Boka</surname><order>28</order></author><author><firstname>Erika</firstname><surname>Korobeinikova</surname><order>29</order></author><author><firstname>Linas</firstname><surname>Kudrevicius</surname><order>30</order></author><author><firstname>Ion</firstname><surname>Apostol</surname><order>31</order></author><author><firstname>Ludmila V</firstname><surname>Eftodiev</surname><order>32</order></author><author><firstname>Alfreda</firstname><surname>Rosca</surname><order>33</order></author><author><firstname>Galina</firstname><surname>Rusnac</surname><order>34</order></author><author><firstname>Mukhabatsho</firstname><surname>Khikmatov</surname><order>35</order></author><author><firstname>Sergii</firstname><surname>Luchkovskyi</surname><order>36</order></author><author><firstname>Yuliia</firstname><surname>Severyn</surname><order>37</order></author><author><firstname>Jamshid M</firstname><surname>Alimov</surname><order>38</order></author><author><firstname>Munojat</firstname><surname>Ismailova</surname><order>39</order></author><author><firstname>Suvsana M</firstname><surname>Talibova</surname><order>40</order></author></authors><documents><document><filename>68198__33353__79ab7e3de62a403b8b91d501e2af30e1.pdf</filename><originalFilename>68198.VoR.pdf</originalFilename><uploaded>2025-01-16T12:04:25.3011675</uploaded><type>Output</type><contentLength>1073923</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2024 The Author(s). 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spelling 2025-01-16T12:07:40.6188870 v2 68198 2024-11-06 Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis efd2f52ea19cb047e01a01e6fa6fa54c 0000-0003-0352-9607 Richard Hugtenburg Richard Hugtenburg true false 2024-11-06 MEDS BackgroundOnly 10–40% of patients with cancer in low-income and middle-income countries were able to access curative or palliative radiotherapy in 2015. We aimed to assess the current status of diagnostic imaging and radiotherapy services in the Baltic countries, eastern Europe, central Asia, and the Caucasus by collecting and analysing local data.MethodsThis Access to Radiotherapy (ART) comprehensive analysis used data from 12 countries: the three Baltic countries (Estonia, Latvia, and Lithuania), two countries in eastern Europe (Moldova and Ukraine), four countries in central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan), and three countries in the Caucasus (Armenia, Azerbaijan, and Georgia), referred to here as the ART countries. We were not able to obtain engagement from Turkmenistan. The primary outcome was to update the extent of shortfalls in the availability of diagnostic imaging and radiotherapy technologies and radiotherapy human resources for patients with cancer in former Soviet Union countries. Following the methods of previous similar studies, we developed three questionnaires—targeted towards radiation oncologists, regulatory authorities, and researchers—requesting detailed information on the availability of these resources. Authors from participating countries sent two copies of the appropriate questionnaire to each of 107 identified institutions and coordinated data collection at the national level. Questionnaires were distributed in English and Russian and responses in both languages were accepted. Two virtual meetings held on May 30 and June 1, 2022, were followed by an in-person workshop held in Almaty, Kazakhstan, in September, 2022, attended by representatives from all participating countries, to discuss and further validate the data submitted up to this point. The data were collected on a dedicated web page, developed by the International Cancer Expert Corps, and were then extracted and analysed.FindingsData were collected between May 10 and Nov 30, 2022. 81 (76%) of the 107 institutions contacted, representing all 12 ART countries, submitted 167 completed questionnaires. The Baltic countries, which are defined as high-income countries, had more diagnostic imaging equipment and radiotherapy human resources (eg, Latvia [1·74] and Lithuania [1·47] have a much higher number of radiation oncologists per 100 000 population than the other ART countries, all of which had <1 radiation oncologist per 100 000 population) and greater radiotherapy technological capacities (higher numbers of linear accelerators and, similar to Georgia, high total external beam radiotherapy capacity) than the other ART countries, as well as high cancer detection rates (Latvia 311 cases per 100 000 population, Lithuania 292, and Estonia 288 vs, for example, 178 in Armenia, 144 in Ukraine, and 72 in Kazakhstan) and low cancer mortality-to-cancer incidence ratios (Estonia 0·43, Latvia 0·49, and Lithuania 0·48; lower than all but Kazakhstan [0·41]). The highest cancer mortality-to-cancer incidence ratios were reported by Moldova (0·71) and Georgia (0·74).InterpretationOur findings show that the number of cancer cases, availability of diagnostic imaging equipment, radiation oncologists and radiotherapy capacity, and cancer mortality-to-cancer incidence ratios all vary substantially across the countries studied, with the three high-income, well resourced Baltic countries performing better in all metrics than the included countries in eastern Europe, central Asia, and the Caucasus. These data highlight the challenges faced by many countries in this study, and might help to justify increased investment of financial, human, and technological resources, with the aim to improve cancer treatment outcomes. Journal Article The Lancet Oncology 25 11 1487 1495 Elsevier BV 1470-2045 1 11 2024 2024-11-01 10.1016/s1470-2045(24)00452-2 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Not Required 2025-01-16T12:07:40.6188870 2024-11-06T14:44:25.5260379 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medical Physics Manjit Dosanjh 1 Vesna Gershan 2 Eugenia C Wendling 3 Jamal S Khader 4 Taofeeq A Ige 5 Mimoza Ristova 6 Richard Hugtenburg 0000-0003-0352-9607 7 Petya Georgieva 8 C Norman Coleman 9 David A Pistenmaa 10 Gohar H Hovhannisyan 11 Tatul Saghatelyan 12 Kamal Kazimov 13 Rovshan Rzayev 14 Gulam R Babayev 15 Mirzali M Aliyev 16 Eduard Gershkevitsh 17 Irina Khomeriki 18 Lily Petriashvili 19 Maia Topeshashvili 20 Raushan Zakirova 21 Aigerim Rakhimova 22 Natalya Karnakova 23 Aralbaev Rakhatbek 24 Narynbek Kazybaev 25 Oksana Bondareva 26 Kristaps Palskis 27 Gaļina Boka 28 Erika Korobeinikova 29 Linas Kudrevicius 30 Ion Apostol 31 Ludmila V Eftodiev 32 Alfreda Rosca 33 Galina Rusnac 34 Mukhabatsho Khikmatov 35 Sergii Luchkovskyi 36 Yuliia Severyn 37 Jamshid M Alimov 38 Munojat Ismailova 39 Suvsana M Talibova 40 68198__33353__79ab7e3de62a403b8b91d501e2af30e1.pdf 68198.VoR.pdf 2025-01-16T12:04:25.3011675 Output 1073923 application/pdf Version of Record true © 2024 The Author(s). This is an Open Access article under the CC BY 4.0 license. true eng https://creativecommons.org/licenses/by/4.0/
title Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
spellingShingle Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
Richard Hugtenburg
title_short Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
title_full Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
title_fullStr Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
title_full_unstemmed Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
title_sort Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis
author_id_str_mv efd2f52ea19cb047e01a01e6fa6fa54c
author_id_fullname_str_mv efd2f52ea19cb047e01a01e6fa6fa54c_***_Richard Hugtenburg
author Richard Hugtenburg
author2 Manjit Dosanjh
Vesna Gershan
Eugenia C Wendling
Jamal S Khader
Taofeeq A Ige
Mimoza Ristova
Richard Hugtenburg
Petya Georgieva
C Norman Coleman
David A Pistenmaa
Gohar H Hovhannisyan
Tatul Saghatelyan
Kamal Kazimov
Rovshan Rzayev
Gulam R Babayev
Mirzali M Aliyev
Eduard Gershkevitsh
Irina Khomeriki
Lily Petriashvili
Maia Topeshashvili
Raushan Zakirova
Aigerim Rakhimova
Natalya Karnakova
Aralbaev Rakhatbek
Narynbek Kazybaev
Oksana Bondareva
Kristaps Palskis
Gaļina Boka
Erika Korobeinikova
Linas Kudrevicius
Ion Apostol
Ludmila V Eftodiev
Alfreda Rosca
Galina Rusnac
Mukhabatsho Khikmatov
Sergii Luchkovskyi
Yuliia Severyn
Jamshid M Alimov
Munojat Ismailova
Suvsana M Talibova
format Journal article
container_title The Lancet Oncology
container_volume 25
container_issue 11
container_start_page 1487
publishDate 2024
institution Swansea University
issn 1470-2045
doi_str_mv 10.1016/s1470-2045(24)00452-2
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medical Physics{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medical Physics
document_store_str 1
active_str 0
description BackgroundOnly 10–40% of patients with cancer in low-income and middle-income countries were able to access curative or palliative radiotherapy in 2015. We aimed to assess the current status of diagnostic imaging and radiotherapy services in the Baltic countries, eastern Europe, central Asia, and the Caucasus by collecting and analysing local data.MethodsThis Access to Radiotherapy (ART) comprehensive analysis used data from 12 countries: the three Baltic countries (Estonia, Latvia, and Lithuania), two countries in eastern Europe (Moldova and Ukraine), four countries in central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan), and three countries in the Caucasus (Armenia, Azerbaijan, and Georgia), referred to here as the ART countries. We were not able to obtain engagement from Turkmenistan. The primary outcome was to update the extent of shortfalls in the availability of diagnostic imaging and radiotherapy technologies and radiotherapy human resources for patients with cancer in former Soviet Union countries. Following the methods of previous similar studies, we developed three questionnaires—targeted towards radiation oncologists, regulatory authorities, and researchers—requesting detailed information on the availability of these resources. Authors from participating countries sent two copies of the appropriate questionnaire to each of 107 identified institutions and coordinated data collection at the national level. Questionnaires were distributed in English and Russian and responses in both languages were accepted. Two virtual meetings held on May 30 and June 1, 2022, were followed by an in-person workshop held in Almaty, Kazakhstan, in September, 2022, attended by representatives from all participating countries, to discuss and further validate the data submitted up to this point. The data were collected on a dedicated web page, developed by the International Cancer Expert Corps, and were then extracted and analysed.FindingsData were collected between May 10 and Nov 30, 2022. 81 (76%) of the 107 institutions contacted, representing all 12 ART countries, submitted 167 completed questionnaires. The Baltic countries, which are defined as high-income countries, had more diagnostic imaging equipment and radiotherapy human resources (eg, Latvia [1·74] and Lithuania [1·47] have a much higher number of radiation oncologists per 100 000 population than the other ART countries, all of which had <1 radiation oncologist per 100 000 population) and greater radiotherapy technological capacities (higher numbers of linear accelerators and, similar to Georgia, high total external beam radiotherapy capacity) than the other ART countries, as well as high cancer detection rates (Latvia 311 cases per 100 000 population, Lithuania 292, and Estonia 288 vs, for example, 178 in Armenia, 144 in Ukraine, and 72 in Kazakhstan) and low cancer mortality-to-cancer incidence ratios (Estonia 0·43, Latvia 0·49, and Lithuania 0·48; lower than all but Kazakhstan [0·41]). The highest cancer mortality-to-cancer incidence ratios were reported by Moldova (0·71) and Georgia (0·74).InterpretationOur findings show that the number of cancer cases, availability of diagnostic imaging equipment, radiation oncologists and radiotherapy capacity, and cancer mortality-to-cancer incidence ratios all vary substantially across the countries studied, with the three high-income, well resourced Baltic countries performing better in all metrics than the included countries in eastern Europe, central Asia, and the Caucasus. These data highlight the challenges faced by many countries in this study, and might help to justify increased investment of financial, human, and technological resources, with the aim to improve cancer treatment outcomes.
published_date 2024-11-01T02:56:14Z
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