ABSTRACT
BACKGROUND: Cancer is the third leading cause of death in the Philippines. Radiotherapy (RT) is integral to the treatment and palliation of cancer. Therefore, RT resources across the country must be surveyed and optimized. METHODS: Online surveys were sent to the heads of all 50 RT facilities in the Philippines. The survey included items regarding the facility itself, personnel, and available services. FINDINGS: The survey had a 98% response rate. 76% of RT facilities in the Philippines are privately owned; 12 are government/public institutions and 8 are academic centers. Over a third are in the National Capital Region; three regions are without a single RT facility. For a population of >110 million, the Philippines has 53 linear accelerators, 125 radiation oncologists, 56 residents, 114 medical physicists, 113 radiation oncology nurses, and 343 radiation therapists. Nine radiation oncology residency programs are active. All facilities are capable of 3D conformal radiotherapy, and 96% are capable of intensity modulated radiotherapy. <30% offer stereotactic radiotherapy, and <50% offer HDR brachytherapy. CONCLUSION: While there has been significant expansion of RT resources over the years, RT remains inaccessible for many in the Philippines. Urgent investment in training and retaining RT personnel is needed as well. Policy summary: With its current cancer burden, the Philippines needs at least 170 linear accelerators, 300 radiation oncologists, and 150 medical physicists. Public/government cancer centers must be built, with priority given to regions without RT facilities. HDR brachytherapy and stereotactic radiotherapy services must also be expanded. A national RT task force must be created to ensure the quality, availability, and accessibility of RT in the Philippines. Further work exploring payment schemes that improve access to RT and mitigate financial toxicity is needed, as well as integration of radiation oncology providers and health policy experts into national health system decision making.
ABSTRACT
Sex disparities in cancer exist along the cancer spectrum, ranging from genomic predisposition and behavioral risk factors to access to screening, diagnostics, treatment, and survivorship care. A growing body of research is studying the biological underpinnings of these differences, from cancer risk to tumor biology to treatment response. It is well known, however, that the social determinants of health play a large role across the cancer disease continuum, which encompasses risk, prevention, diagnosis, treatment, survivorship, rehabilitation, and palliative care. Less literature focuses on the gendered disparities that are epidemiologic in nature, especially in Southeast Asia (SEA), a diverse region that is home to nearly 670 million people, where most are lower middle income countries, and where socioeconomic and cultural factors increase cancer risk for women. In this review, we highlight the social drivers of gendered disparities, namely the geographic, environmental, sociocultural, economic, and political forces that contribute to the increased mortality and poorer health outcomes in the region.
ABSTRACT
In 2020, breast and cervical cancer were the top 2 cancers among Filipino women in terms of incidence. In the Philippines, a lower-middle income country in Southeast Asia with more than 50 million women, majority of breast and cervical cancer patients are diagnosed at advanced stages, as high out-of-pocket healthcare costs, the centralization of health human resources and infrastructure in the capital, and the absence of organized national screening programs preclude access to breast and cervical cancer screening. Low health literacy and gendered sociocultural pressures among Filipino women compound these systemic challenges. The recent passage of the Universal Health Care Law and the National Integrated Cancer Control Act in the Philippines is an opportunity to reduce disparities in access to cancer screening, with implications for other low- and middle-income countries that may face parallel challenges.
