RESUMO
PURPOSE: To estimate the supply and demand of current and future radiation therapy services by 2035 for Colombia. METHODS AND MATERIALS: The present study was performed by surveying different radiation therapy services identified in Colombia through the Colombian Association of Radiation Oncology. The demand was estimated based on incident cases and published information on the use of radiation therapy by type of cancer. Future demand was estimated under the assumption that incidence rates do not change and therefore the change in the number of cases is due to the change in the age structure of the Colombian population. Sensitivity analyses were conducted on the percentage of radiation therapy use by type of cancer. A Monte Carlo simulation was carried out to estimate the distribution of cases requiring radiation therapy, the amount of equipment, and the number of staff needed for care with the use of this technology. RESULTS: In total, Colombia has 69 linear accelerators, 2 radiosurgery equipment, 30 high-dose-rate brachytherapy pieces of equipment, 124 radiation therapy oncologists (113 working, 9 not working, and 2 not informed), and 275 radiation therapy technologists as of June 2020. It was estimated that to meet the current cancer burden the country would need a total of 162 radiation therapy oncologists, 121 medical physicists, and 323 radiation therapy technologists and to increase the number of radiation therapy technologists, radiation therapy oncologists, and medical physicists to 491, 246, and 184, respectively, to meet the disease burden by 2035 (73,684-88,743 cases per year). CONCLUSIONS: In Colombia it is estimated that there is a deficit of human resources and technology for radiation therapy; therefore, there is need to investment resources from the public and private sectors to provide timely and quality care to cancer patients requiring this treatment.
RESUMO
Resumen Objetivo: Demostrar el efecto de los cambios demográficos previstos por la CEPAL en la carga de cáncer en nuestro país. Método: Se estableció el número de casos nuevos de cáncer en las primeras cinco localizaciones en mayores de 15 años, mediante las tasas de incidencia de cáncer para cada departamento, Bogotá y el grupo Amazonas estimadas por el Instituto Nacional de Cancerología y las proyecciones poblacionales del 2020 del DANE y del 2050 de la CEPAL. Resultados: El número de estos casos nuevos subiría un 28% en los hombres y un 25% en las mujeres en el 2020; pero en el 2050 el incremento sería del 58% en ambos sexos. La enfermedad en estas localizaciones se concentraría mucho más en mayores de 65 años, ya que pasaría del 62% al 75% en el 2050 en hombres y del 33% al 53% en mujeres. Más de las tres cuartas partes de ellos serían de próstata, estómago y pulmón en hombres, y en las mujeres de mama, cuello uterino y colorrectal, en la mayoría de los departamentos del país. Conclusiones: Es necesario reflexionar sobre la construcción de la política pública de atención en salud oncológica; sobre la medición, comparación y difusión de los resultados, de la prevención y detección oportuna; y sobre el significado de la atención de cáncer en personas mayores, la asistencia paliativa en todos los niveles con enfoque de salud pública y la protección social de los cuidadores.
Abstract Objective: To demonstrate the effect of demographic changes envisaged by the Economic Commission for Latin America and the Caribbean (ECLAC) on the burden of cancer in Colombia. Method: The number of new cases of cancer was established in the top five locations in patients > 15 years-old, using the incidence rates of cancer for each Department, Bogotá, and the Amazonas group, estimated by the National Cancer Institute of Colombia and the population projections for 2020 by the National Administrative Department of Statistics (NADS), and 2050 by ECLAC. Results: The number of these new cases could increase by 28% in men and 25% in women by 2020, but by 2050 the increase would be 58% in both sexes. The disease in these locations would be concentrated much more in people over 65 in 2050, from 62% to 75% in men and 33% to 53% in women. More than three-quarters of them would be prostate, stomach, and lung cancer in men, and in women breast, cervical and colorectal cancer in most Departments of the country. Conclusions: It is necessary to reflect on the construction of public policy on cancer health care, by measuring, comparing and disseminating the results of prevention and timely detection by health providers. Reflection is also required on the diagnostic and treatment services available in all regions and in the meaning of cancer care in the elderly, palliative care at all levels with a focus on public health, and social support for caregivers.
