1035 - Global Efforts to Reduce Pediatric Cancer Care Disparities: A Decade Change
Presenter(s)
R. Mailhot Vega1, D. J. Indelicato2, J. Parkes3, N. Esiashvili4, J. A. Hernandez Benitez5, M. Mikhail-Lette6, O. Cirajc Bjelac6, D. Berger6, E. Ciurana Casademont6, Y. Anacak6, and L. C. Mendez6; 1Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, 2Department of Radiation Oncology, University of Florida, Jacksonville, FL, 3Groote Schuur Hospital and the University of Cape Town, Cape Town, South Africa, 4Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, 5Department of Radiation Oncology, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Neuvo León, Monterrey, Mexico, 6Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
Purpose/Objective(s): We present an update on the status, needs, and challenges faced by pediatric imaging and radiotherapy (RT) programs globally after a previous survey conducted by the International Atomic Energy Agency (IAEA) 10 years prior.
Materials/Methods: A 121-question survey was developed and distributed to radiation oncologists, medical physicists and radiologists from participating Member States (MS) through IAEA channels to MS representatives. It included questions on radiation oncology, imaging, nutrition, human capacity to support these services, quality assurance practices and other aspects of childhood cancer management. Questions evaluated radiation oncology practices, access to and standards of diagnostic radiology and nutrition in childhood cancer patients, treatment planning procedures, RT techniques, use of anesthesia, availability of multidisciplinary tumour boards, and other topics specific to childhood cancer care. Descriptive statistics were used to compare response rates by income level based on the World Bank country classification.
Results: Forty-seven IAEA MS completed the survey. Using the World Bank country classification by income level, 26% were High (H), 38% Upper-Middle (UM), 23% Lower-Middle (LM), and 13% Low (L) income nations. Most institutions who participated in the survey, regardless of country income level, had departments providing essential services of pediatric oncology, anesthesia, and radiology. Disparities in access exist regarding nuclear medicine (92% v 33%), PET imaging (58% vs 0%), linear accelerators (100% vs 33%), quality assurance (58% vs 33%) and hospice service (67% vs 17%) favoring H vs L nations (67% vs 17%). Medical physics presence for radiation oncology was consistent across income level, whereas access to it was scarce in medical imaging. Medical physics staffing did differ based on income level, with on average 11 medical physicists per department in H countries vs 6 in L countries. Regarding diagnostic imaging, most respondents reported access to computed tomography but access to other advanced imaging technologies was limited.
Conclusion: While there have been improvements in access to certain aspects of pediatric cancer care compared to the previous survey, disparities persist particularly in low- and middle-income countries. There’s a need for more specialized training, better access to imaging and RT technology, funding these efforts, standardizing the necessary tools and staffing for a successful pediatric program, and improved ancillary services. These findings and recommendations can inform policy and decision-making authorities towards the WHO’s 2030 goal for childhood cancer.