Josep M Borras1, Yolande Lievens2, Cai Grau3. 1. a Department of Clinical Sciences , University of Barcelona, IDIBELL, Hospitalet , Barcelona , Spain. 2. b Radiation Oncology Department,Ghent University Hospital , Ghent , Belgium. 3. c Department of Oncology , Aarhus University Hospital , Aarhus , Denmark.
Abstract
BACKGROUND: Planning radiation oncology equipment and staffing is necessary in public healthcare systems in Europe. METHODS: Three different data inputs were considered: evidence-based indications for radiotherapy, the incidence of cancer, and the stage at diagnosis of each cancer type, both the latter using population-based data from cancer registries. The availability of these data and the implications for the estimation of the proportion of new cancer patients who would need radiotherapy treatment at least once during the course of the disease is reviewed. RESULTS: Depending on the frequency of cancers and the stage at diagnosis, it has been estimated that between 47% and 53% of incident cases among European countries would require external beam radiotherapy. When the actual data of utilization is compared with the evidence-based target, only one country in Europe has achieved full coverage. CONCLUSION: It is argued that these should be considered the optimal proportions of cancer patients, but a more realistic policy target could be set at 80% or higher of the optimal proportion. This realistic target also takes into account the inherent uncertainties in the assessment of evidence, and other factors that influence clinical decision-making in cases of multi-morbidity or patient preferences. Other factors are associated with problems that should be dealt with in the framework of a cancer plan, such as accessibility, preference bias in physician evaluation of the indication or shortage of resources, and the impact of the reimbursement system. Finally, it is argued that a cancer plan is the framework for achieving policy targets in the appropriate coverage of the evidence-based indications for radiation oncology forecasts.
BACKGROUND: Planning radiation oncology equipment and staffing is necessary in public healthcare systems in Europe. METHODS: Three different data inputs were considered: evidence-based indications for radiotherapy, the incidence of cancer, and the stage at diagnosis of each cancer type, both the latter using population-based data from cancer registries. The availability of these data and the implications for the estimation of the proportion of new cancerpatients who would need radiotherapy treatment at least once during the course of the disease is reviewed. RESULTS: Depending on the frequency of cancers and the stage at diagnosis, it has been estimated that between 47% and 53% of incident cases among European countries would require external beam radiotherapy. When the actual data of utilization is compared with the evidence-based target, only one country in Europe has achieved full coverage. CONCLUSION: It is argued that these should be considered the optimal proportions of cancerpatients, but a more realistic policy target could be set at 80% or higher of the optimal proportion. This realistic target also takes into account the inherent uncertainties in the assessment of evidence, and other factors that influence clinical decision-making in cases of multi-morbidity or patient preferences. Other factors are associated with problems that should be dealt with in the framework of a cancer plan, such as accessibility, preference bias in physician evaluation of the indication or shortage of resources, and the impact of the reimbursement system. Finally, it is argued that a cancer plan is the framework for achieving policy targets in the appropriate coverage of the evidence-based indications for radiation oncology forecasts.
Authors: A Rodríguez; J M Borrás; J López-Torrecilla; M Algara; A Palacios-Eito; A Gómez-Caamaño; L Olay; P C Lara Journal: Clin Transl Oncol Date: 2016-08-04 Impact factor: 3.405
Authors: May Ingvild Volungholen Sollid; Marit Slaaen; Signe Danielsen; Øyvind Kirkevold Journal: Int J Qual Health Care Date: 2022-09-15 Impact factor: 2.257