S. A. R. AlKhatib1, O. Ciraj Bjelac2, K. Akperov3, V. Hande4, and M. Abdel-Wahab5; 1Henry Ford Health, Detroit, MI, 2IAEA, Vienna, Austria, 3National Centre of Oncology, Baku, Azerbaijan, 4Nagasaki University, Japan, Japan, 5International Atomic Energy Agency, Vienna, Austria
Purpose/Objective(s): Radiation therapy is an important component of cancer treatment. In low- and middle-income countries (LMICs), where more than two-thirds of cancer mortality occur, the lack of radiation oncology resources is becoming more pressing. Asia has 60% of the worlds population and bears half of the global cancer burden. Due to its wide terrain and varied healthcare systems, Central Asia, which includes Kazakhstan, Uzbekistan, Turkmenistan, Kyrgyzstan, and Tajikistan, presents special difficulties in providing effective medical imaging and radiotherapy services. Materials/
Methods: We conducted a longitudinal review of the state of radiation oncology resources in Central Asia to analyze the regions growth, existing condition, and future needs. Information was supplemented through the Directory of Radiotherapy Centers, available from the International Atomic Energy Agencys most recent report. The GLOBOCAN 2020 database of the International Agency for Research on Cancer was used to determine current cancer incidence rates and make projections for the future. The goal of this analysis is to provide an updated overview of radiation resources in Central Asia as well as to examine the gaps, challenges, and needs in these countries. Results: As of December 2022, there are 75 megavoltage machines (53 cobalt-60 and 22 linear accelerators) spread among the five nations. Kazakhstan has 60% (45/75) of the megavoltage machines and 72% (16/22) of the linear accelerators. Additionally, there are 35 brachytherapy units, of which all but two are high-dose rate brachytherapy. Using GLOBOCAN 2020, the most recent cancer projections, the amount of megavoltage units per million people ranged from 0,1-0,2 in Tajikistan, Kyrgyzstan and Uzbekistan to 2,3 in Kazakhstan. The number of megavoltage units per 1000 cancer cases ranged from 0.1 in Kyrgyzstan to 1.2 in Kazakhstan. Our study examined the link between a countrys machine capacity rate for radiotherapy and its GNI per capita. We found a significant correlation between GNI per capita and megavoltage capacity occupation rate in Central Asia (R² = 0.89, p = 0.014). By 2030, a minimum of 115-185 megavoltage machines would be required to meet the demand. However, as of December 2022, only 75 devices are available and distributed. Conclusion: As of December 2022, all of these countries had at least two teletherapy machines. While significant progress has been made, challenges remain in ensuring equitable access to radiation services throughout Central Asia. Continued efforts, including infrastructure investment, personnel training, and international collaboration, are required to meet the regions evolving cancer care needs.
