Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

The APROSIG-National Cancer Centre collaboration: expanding access to radiation therapy in Cambodia  (#43)

Mei Ling Yap 1 2 3 4 , I Ward 5
  1. Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW
  2. School of Medicine, Western Sydney University, Campbelltown, NSW
  3. Cancer Research Division, Cancer Council NSW, Kings Cross, NSW
  4. Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia
  5. Canterbury Regional Cancer and Haematology Service, Christchurch, New Zealand

The incidence of cancer is rising rapidly, with a global projection of 26 million cases annually by 2040; 70% of these will arise in low and middle-income countries (LMICs)1. Radiotherapy is a core component of cancer care and has been shown to be cost-effective2. However, there remains a huge deficit in radiotherapy services in LMICs, with the provision of resources inversely proportional to Gross National Income3. By geographic region, the Asia-Pacific has been demonstrated to have the highest absolute deficit in radiotherapy services4 and the largest investments required to meet those needs. The Global Task Force in Radiotherapy for Cancer Control Lancet Commission demonstrated that in addition to the need for radiotherapy equipment, there is an urgent need for human resources2. At present, there is a shortage of in-country training pathways for radiotherapy professionals in many LMICs in the Asia-Pacific.

One such country facing a shortage of radiotherapy resources is Cambodia, which has one linear accelerator for a population of 16 million people. An exciting development has been a recently-built comprehensive cancer centre in Phnom Penh, the National Cancer Centre (NCC), which includes modern radiotherapy services. A major challenge for NCC has been workforce, given the specialized skills required and lack of formal training programs within Cambodia. 

The Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) of the Royal Australian and New Zealand College of Radiologists (RANZCR) has partnered with NCC, primarily in aiding with education and training of radiation oncology staff. APROSIG is a volunteer group which aims to support the safe and effective delivery of radiotherapy in neighbouring LMICs. Initiatives have included the organization of in-country Australian radiation therapist trainers in Cambodia for 6-15 months’ duration and an observership program for Cambodian cancer professionals in Sydney; both programs supported by the Australian government.

  1. Ferlay JEM, Lam F, Colombet M, et al. Cancer tomorrow. http://gco.iarc.fr/tomorrow (accessed Sept 4th, 2019)
  2. Atun R, Jaffray DA, Barton MB, et al. Expanding global access to radiotherapy. Lancet Oncol 2015;16(10):1153-86.
  3. Levin V, Tatsuzaki H. Radiotherapy services in countries in transition: gross national income per capita as a significant factor. Radiother Oncol. 2002;63(2):147-50.
  4. Zubizarreta E, Van Dyk J, Lievens Y. Analysis of Global Radiotherapy Needs and Costs by Geographic Region and Income Level. Clin Oncol 2017;29(2):84-92