Linacs to narrow radiotherapy gap
A technology initiative launched at CERN to address the lack of radiotherapy in low- and middle-income countries is preparing for its first linear-accelerator prototype, write Deepa Angal-Kalinin, Graeme Burt and Manjit Dosanjh
By 2040, the annual global incidence of cancer is expected to rise by more than 42% from 19.3 million to 27.5 million cases, corresponding to approximately 16.3 million deaths. Shockingly, some 70% of these new cases will be in low- and middle-income countries (LMICs), which lack the healthcare programmes required to effectively manage their cancer burden. While it is estimated that about half of all cancer patients would benefit from radiotherapy (RT) for treatment, there is a significant shortage of RT machines outside high-income countries.
More than 10,000 electron linear accelerators (linacs) are currently used worldwide to treat patients with cancer. But only 10% of patients in low-income and 40% in middle-income countries who need RT have access to it. Patients face long waiting times, are forced to travel to neighbouring regions or face insurmountable expenditure to access treatment. In Africa alone, 27 out of 55 countries have no linac-based RT facilities. In those that do, the ratio of the number of machines to people ranges from one machine to 423,000 people in Mauritius, one machine to almost five million people in Kenya and one machine to more than 100 million people in Ethiopia. In high-income countries such as the US, Switzerland, Canada and the UK, by contrast, the ratio is one RT machine to 85,000, 102,000, 127,000 and 187,000 people, respectively. To draw another stark comparison, Africa has approximately 380 linacs for a population of 1.2 billion while the US has almost 4000 linacs for a population of 331 million.