Do all Canadians for whom radiotherapy (RT) is indicated receive it? A recently published systematic review of Canadian literature has identified factors which may contribute to suboptimal use of radiation therapy in Canada.
In a 2009 Cancer System Quality Index (CSQI) report, Ontario adopted a benchmark for RT utilisation, based on the estimate that 48% of those receiving a cancer diagnosis would require RT at some point in the course of their disease. Studies in other countries have made similar estimates.
Current Canadian utilisation rates fall below this benchmark, as can be suggested by the fact that 32.8% of those diagnosed with cancer in Ontario, and 31% nationally, are receiving a course of RT within two years of diagnosis. A number of factors may be contributing to suboptimal RT utilisation rates, from those attributable to the health care system to those relating directly to the patient and the provider.
The most cited barriers to accessing RT when indicated were patient age, distance to treatment centre, waiting times and lack of physician understanding about the use of RT. While such factors as patient age, distance to treatment centre, and wait times were prevalent and expected, the role of the provider as a barrier to RT, and the lack of information pertaining to patient fears and misbeliefs were unexpected findings in this review and demand further attention.
The paper’s authors recommend that solutions should be found to overcome identified barriers in order to facilitate more effective cancer care for Canadians. They state that future work should focus on prioritising barriers, developing implementable solutions, and performing cost/effort analyses to determine where the greatest benefit might be achieved. Education, both of patients and providers, is expected to play a significant role in devising solutions.
Barriers to accessing radiation therapy in Canada: a systematic review
Caitlin Gillan, Kaleigh Briggs, Alejandro Goytisolo Pazos, Melanie Maurus, Nicole Harnett, Pamela Catton and David Wiljer. Radiation Oncology 2012, 7:167 doi:10.1186/1748-717X-7-167
Source: www.ro-journal.com
