Expanding global access to radiotherapy.
Identifieur interne : 002929 ( PubMed/Corpus ); précédent : 002928; suivant : 002930Expanding global access to radiotherapy.
Auteurs : Rifat Atun ; David A. Jaffray ; Michael B. Barton ; Freddie Bray ; Michael Baumann ; Bhadrasain Vikram ; Timothy P. Hanna ; Felicia M. Knaul ; Yolande Lievens ; Tracey Y M. Lui ; Michael Milosevic ; Brian O'Sullivan ; Danielle L. Rodin ; Eduardo Rosenblatt ; Jacob Van Dyk ; Mei Ling Yap ; Eduardo Zubizarreta ; Mary GospodarowiczSource :
- The Lancet. Oncology [ 1474-5488 ] ; 2015.
English descriptors
- KwdEn :
- Cost-Benefit Analysis, Developing Countries (economics), Diffusion of Innovation, Forecasting, Global Health (economics), Global Health (trends), Health Care Costs (trends), Health Services Accessibility (economics), Health Services Accessibility (trends), Healthcare Disparities (economics), Healthcare Disparities (trends), Humans, Models, Economic, National Health Programs (economics), National Health Programs (trends), Neoplasms (diagnosis), Neoplasms (economics), Neoplasms (mortality), Neoplasms (radiotherapy), Radiotherapy (economics), Socioeconomic Factors, Time Factors, Treatment Outcome.
- MESH :
- diagnosis : Neoplasms.
- economics : Developing Countries, Global Health, Health Services Accessibility, Healthcare Disparities, National Health Programs, Neoplasms, Radiotherapy.
- mortality : Neoplasms.
- radiotherapy : Neoplasms.
- trends : Global Health, Health Care Costs, Health Services Accessibility, Healthcare Disparities, National Health Programs.
- Cost-Benefit Analysis, Diffusion of Innovation, Forecasting, Humans, Models, Economic, Socioeconomic Factors, Time Factors, Treatment Outcome.
Abstract
Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even greater total benefit of $365·4 billion ($12·8 billion in low-income countries, $67·7 billion in lower-middle-income countries, and $284·7 billion in upper-middle-income countries). The returns, by the human-capital approach, are projected to be less with the nominal cost model, amounting to $16·9 billion in 2015-35 (-$14·9 billion in low-income countries; -$18·7 billion in lower-middle-income countries, and $50·5 billion in upper-middle-income countries). The returns with the efficiency model were projected to be greater, however, amounting to $104·2 billion (-$2·4 billion in low-income countries, $10·7 billion in lower-middle-income countries, and $95·9 billion in upper-middle-income countries). Our results provide compelling evidence that investment in radiotherapy not only enables treatment of large numbers of cancer cases to save lives, but also brings positive economic benefits.
DOI: 10.1016/S1470-2045(15)00222-3
PubMed: 26419354
Links to Exploration step
pubmed:26419354Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Expanding global access to radiotherapy.</title><author><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name><affiliation><nlm:affiliation>Harvard TH Chan School of Public Health, Harvard University, Cambridge, MA, USA. Electronic address: ratun@hsph.harvard.edu.</nlm:affiliation></affiliation></author><author><name sortKey="Jaffray, David A" sort="Jaffray, David A" uniqKey="Jaffray D" first="David A" last="Jaffray">David A. Jaffray</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; TECHNA Institute, University Health Network, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Barton, Michael B" sort="Barton, Michael B" uniqKey="Barton M" first="Michael B" last="Barton">Michael B. Barton</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bray, Freddie" sort="Bray, Freddie" uniqKey="Bray F" first="Freddie" last="Bray">Freddie Bray</name><affiliation><nlm:affiliation>International Agency for Research on Cancer, Lyon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Baumann, Michael" sort="Baumann, Michael" uniqKey="Baumann M" first="Michael" last="Baumann">Michael Baumann</name><affiliation><nlm:affiliation>Department of Radiation Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Vikram, Bhadrasain" sort="Vikram, Bhadrasain" uniqKey="Vikram B" first="Bhadrasain" last="Vikram">Bhadrasain Vikram</name><affiliation><nlm:affiliation>National Cancer Institute, US National Institutes of Health, Bethesda, MD, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hanna, Timothy P" sort="Hanna, Timothy P" uniqKey="Hanna T" first="Timothy P" last="Hanna">Timothy P. Hanna</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia; Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Knaul, Felicia M" sort="Knaul, Felicia M" uniqKey="Knaul F" first="Felicia M" last="Knaul">Felicia M. Knaul</name><affiliation><nlm:affiliation>Harvard Global Equity Initiative, Harvard University, Cambridge, MA, USA; Harvard Medical School, Harvard University, Cambridge, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Lievens, Yolande" sort="Lievens, Yolande" uniqKey="Lievens Y" first="Yolande" last="Lievens">Yolande Lievens</name><affiliation><nlm:affiliation>Ghent University Hospital, Ghent, Belgium; Ghent University, Ghent, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Lui, Tracey Y M" sort="Lui, Tracey Y M" uniqKey="Lui T" first="Tracey Y M" last="Lui">Tracey Y M. Lui</name><affiliation><nlm:affiliation>TECHNA Institute, University Health Network, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Milosevic, Michael" sort="Milosevic, Michael" uniqKey="Milosevic M" first="Michael" last="Milosevic">Michael Milosevic</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rodin, Danielle L" sort="Rodin, Danielle L" uniqKey="Rodin D" first="Danielle L" last="Rodin">Danielle L. Rodin</name><affiliation><nlm:affiliation>Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rosenblatt, Eduardo" sort="Rosenblatt, Eduardo" uniqKey="Rosenblatt E" first="Eduardo" last="Rosenblatt">Eduardo Rosenblatt</name><affiliation><nlm:affiliation>International Atomic Energy Agency, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Van Dyk, Jacob" sort="Van Dyk, Jacob" uniqKey="Van Dyk J" first="Jacob" last="Van Dyk">Jacob Van Dyk</name><affiliation><nlm:affiliation>Department of Medical Biophysics, Western University, London, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Yap, Mei Ling" sort="Yap, Mei Ling" uniqKey="Yap M" first="Mei Ling" last="Yap">Mei Ling Yap</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Zubizarreta, Eduardo" sort="Zubizarreta, Eduardo" uniqKey="Zubizarreta E" first="Eduardo" last="Zubizarreta">Eduardo Zubizarreta</name><affiliation><nlm:affiliation>Global Task Force on Radiotherapy for Cancer Control, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Gospodarowicz, Mary" sort="Gospodarowicz, Mary" uniqKey="Gospodarowicz M" first="Mary" last="Gospodarowicz">Mary Gospodarowicz</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:26419354</idno><idno type="pmid">26419354</idno><idno type="doi">10.1016/S1470-2045(15)00222-3</idno><idno type="wicri:Area/PubMed/Corpus">002929</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002929</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Expanding global access to radiotherapy.</title><author><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name><affiliation><nlm:affiliation>Harvard TH Chan School of Public Health, Harvard University, Cambridge, MA, USA. Electronic address: ratun@hsph.harvard.edu.</nlm:affiliation></affiliation></author><author><name sortKey="Jaffray, David A" sort="Jaffray, David A" uniqKey="Jaffray D" first="David A" last="Jaffray">David A. Jaffray</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; TECHNA Institute, University Health Network, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Barton, Michael B" sort="Barton, Michael B" uniqKey="Barton M" first="Michael B" last="Barton">Michael B. Barton</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Bray, Freddie" sort="Bray, Freddie" uniqKey="Bray F" first="Freddie" last="Bray">Freddie Bray</name><affiliation><nlm:affiliation>International Agency for Research on Cancer, Lyon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Baumann, Michael" sort="Baumann, Michael" uniqKey="Baumann M" first="Michael" last="Baumann">Michael Baumann</name><affiliation><nlm:affiliation>Department of Radiation Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Vikram, Bhadrasain" sort="Vikram, Bhadrasain" uniqKey="Vikram B" first="Bhadrasain" last="Vikram">Bhadrasain Vikram</name><affiliation><nlm:affiliation>National Cancer Institute, US National Institutes of Health, Bethesda, MD, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hanna, Timothy P" sort="Hanna, Timothy P" uniqKey="Hanna T" first="Timothy P" last="Hanna">Timothy P. Hanna</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia; Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Knaul, Felicia M" sort="Knaul, Felicia M" uniqKey="Knaul F" first="Felicia M" last="Knaul">Felicia M. Knaul</name><affiliation><nlm:affiliation>Harvard Global Equity Initiative, Harvard University, Cambridge, MA, USA; Harvard Medical School, Harvard University, Cambridge, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Lievens, Yolande" sort="Lievens, Yolande" uniqKey="Lievens Y" first="Yolande" last="Lievens">Yolande Lievens</name><affiliation><nlm:affiliation>Ghent University Hospital, Ghent, Belgium; Ghent University, Ghent, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Lui, Tracey Y M" sort="Lui, Tracey Y M" uniqKey="Lui T" first="Tracey Y M" last="Lui">Tracey Y M. Lui</name><affiliation><nlm:affiliation>TECHNA Institute, University Health Network, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Milosevic, Michael" sort="Milosevic, Michael" uniqKey="Milosevic M" first="Michael" last="Milosevic">Michael Milosevic</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rodin, Danielle L" sort="Rodin, Danielle L" uniqKey="Rodin D" first="Danielle L" last="Rodin">Danielle L. Rodin</name><affiliation><nlm:affiliation>Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rosenblatt, Eduardo" sort="Rosenblatt, Eduardo" uniqKey="Rosenblatt E" first="Eduardo" last="Rosenblatt">Eduardo Rosenblatt</name><affiliation><nlm:affiliation>International Atomic Energy Agency, Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Van Dyk, Jacob" sort="Van Dyk, Jacob" uniqKey="Van Dyk J" first="Jacob" last="Van Dyk">Jacob Van Dyk</name><affiliation><nlm:affiliation>Department of Medical Biophysics, Western University, London, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Yap, Mei Ling" sort="Yap, Mei Ling" uniqKey="Yap M" first="Mei Ling" last="Yap">Mei Ling Yap</name><affiliation><nlm:affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Zubizarreta, Eduardo" sort="Zubizarreta, Eduardo" uniqKey="Zubizarreta E" first="Eduardo" last="Zubizarreta">Eduardo Zubizarreta</name><affiliation><nlm:affiliation>Global Task Force on Radiotherapy for Cancer Control, Toronto, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Gospodarowicz, Mary" sort="Gospodarowicz, Mary" uniqKey="Gospodarowicz M" first="Mary" last="Gospodarowicz">Mary Gospodarowicz</name><affiliation><nlm:affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Lancet. Oncology</title><idno type="eISSN">1474-5488</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Developing Countries (economics)</term><term>Diffusion of Innovation</term><term>Forecasting</term><term>Global Health (economics)</term><term>Global Health (trends)</term><term>Health Care Costs (trends)</term><term>Health Services Accessibility (economics)</term><term>Health Services Accessibility (trends)</term><term>Healthcare Disparities (economics)</term><term>Healthcare Disparities (trends)</term><term>Humans</term><term>Models, Economic</term><term>National Health Programs (economics)</term><term>National Health Programs (trends)</term><term>Neoplasms (diagnosis)</term><term>Neoplasms (economics)</term><term>Neoplasms (mortality)</term><term>Neoplasms (radiotherapy)</term><term>Radiotherapy (economics)</term><term>Socioeconomic Factors</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Developing Countries</term><term>Global Health</term><term>Health Services Accessibility</term><term>Healthcare Disparities</term><term>National Health Programs</term><term>Neoplasms</term><term>Radiotherapy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Global Health</term><term>Health Care Costs</term><term>Health Services Accessibility</term><term>Healthcare Disparities</term><term>National Health Programs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Diffusion of Innovation</term><term>Forecasting</term><term>Humans</term><term>Models, Economic</term><term>Socioeconomic Factors</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even greater total benefit of $365·4 billion ($12·8 billion in low-income countries, $67·7 billion in lower-middle-income countries, and $284·7 billion in upper-middle-income countries). The returns, by the human-capital approach, are projected to be less with the nominal cost model, amounting to $16·9 billion in 2015-35 (-$14·9 billion in low-income countries; -$18·7 billion in lower-middle-income countries, and $50·5 billion in upper-middle-income countries). The returns with the efficiency model were projected to be greater, however, amounting to $104·2 billion (-$2·4 billion in low-income countries, $10·7 billion in lower-middle-income countries, and $95·9 billion in upper-middle-income countries). Our results provide compelling evidence that investment in radiotherapy not only enables treatment of large numbers of cancer cases to save lives, but also brings positive economic benefits.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26419354</PMID><DateCreated><Year>2015</Year><Month>09</Month><Day>30</Day></DateCreated><DateCompleted><Year>2016</Year><Month>01</Month><Day>04</Day></DateCompleted><DateRevised><Year>2015</Year><Month>09</Month><Day>30</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1474-5488</ISSN><JournalIssue CitedMedium="Internet"><Volume>16</Volume><Issue>10</Issue><PubDate><Year>2015</Year><Month>Sep</Month></PubDate></JournalIssue><Title>The Lancet. Oncology</Title><ISOAbbreviation>Lancet Oncol.</ISOAbbreviation></Journal><ArticleTitle>Expanding global access to radiotherapy.</ArticleTitle><Pagination><MedlinePgn>1153-86</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/S1470-2045(15)00222-3</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1470-2045(15)00222-3</ELocationID><Abstract><AbstractText>Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even greater total benefit of $365·4 billion ($12·8 billion in low-income countries, $67·7 billion in lower-middle-income countries, and $284·7 billion in upper-middle-income countries). The returns, by the human-capital approach, are projected to be less with the nominal cost model, amounting to $16·9 billion in 2015-35 (-$14·9 billion in low-income countries; -$18·7 billion in lower-middle-income countries, and $50·5 billion in upper-middle-income countries). The returns with the efficiency model were projected to be greater, however, amounting to $104·2 billion (-$2·4 billion in low-income countries, $10·7 billion in lower-middle-income countries, and $95·9 billion in upper-middle-income countries). Our results provide compelling evidence that investment in radiotherapy not only enables treatment of large numbers of cancer cases to save lives, but also brings positive economic benefits.</AbstractText><CopyrightInformation>Copyright © 2015 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Atun</LastName><ForeName>Rifat</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Harvard TH Chan School of Public Health, Harvard University, Cambridge, MA, USA. Electronic address: ratun@hsph.harvard.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jaffray</LastName><ForeName>David A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; TECHNA Institute, University Health Network, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barton</LastName><ForeName>Michael B</ForeName><Initials>MB</Initials><AffiliationInfo><Affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bray</LastName><ForeName>Freddie</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>International Agency for Research on Cancer, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baumann</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vikram</LastName><ForeName>Bhadrasain</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>National Cancer Institute, US National Institutes of Health, Bethesda, MD, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hanna</LastName><ForeName>Timothy P</ForeName><Initials>TP</Initials><AffiliationInfo><Affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia; Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Knaul</LastName><ForeName>Felicia M</ForeName><Initials>FM</Initials><AffiliationInfo><Affiliation>Harvard Global Equity Initiative, Harvard University, Cambridge, MA, USA; Harvard Medical School, Harvard University, Cambridge, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lievens</LastName><ForeName>Yolande</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Ghent University Hospital, Ghent, Belgium; Ghent University, Ghent, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lui</LastName><ForeName>Tracey Y M</ForeName><Initials>TY</Initials><AffiliationInfo><Affiliation>TECHNA Institute, University Health Network, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Milosevic</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>O'Sullivan</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodin</LastName><ForeName>Danielle L</ForeName><Initials>DL</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rosenblatt</LastName><ForeName>Eduardo</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>International Atomic Energy Agency, Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Van Dyk</LastName><ForeName>Jacob</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Medical Biophysics, Western University, London, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yap</LastName><ForeName>Mei Ling</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zubizarreta</LastName><ForeName>Eduardo</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Global Task Force on Radiotherapy for Cancer Control, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gospodarowicz</LastName><ForeName>Mary</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Lancet Oncol</MedlineTA><NlmUniqueID>100957246</NlmUniqueID><ISSNLinking>1470-2045</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1148-9</RefSource><PMID Version="1">26419351</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1144-6</RefSource><PMID Version="1">26419349</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1149-50</RefSource><PMID Version="1">26419352</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1151-2</RefSource><PMID Version="1">26419353</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1143</RefSource><PMID Version="1">26419348</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Oncol. 2015 Sep;16(10):1146-7</RefSource><PMID Version="1">26419350</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003906" MajorTopicYN="N">Developing Countries</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004059" MajorTopicYN="N">Diffusion of Innovation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005544" MajorTopicYN="N">Forecasting</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014943" MajorTopicYN="N">Global Health</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017048" MajorTopicYN="Y">Health Care Costs</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006297" MajorTopicYN="N">Health Services Accessibility</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D054625" MajorTopicYN="N">Healthcare Disparities</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018803" MajorTopicYN="N">Models, Economic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009313" MajorTopicYN="N">National Health Programs</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009369" MajorTopicYN="N">Neoplasms</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000532" MajorTopicYN="Y">radiotherapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011878" MajorTopicYN="N">Radiotherapy</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012959" MajorTopicYN="N">Socioeconomic Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>07</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>08</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>08</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>10</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>10</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>1</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26419354</ArticleId><ArticleId IdType="pii">S1470-2045(15)00222-3</ArticleId><ArticleId IdType="doi">10.1016/S1470-2045(15)00222-3</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Asie/explor/AustralieFrV1/Data/PubMed/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002929 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd -nk 002929 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Asie
|area= AustralieFrV1
|flux= PubMed
|étape= Corpus
|type= RBID
|clé= pubmed:26419354
|texte= Expanding global access to radiotherapy.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/RBID.i -Sk "pubmed:26419354" \
| HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a AustralieFrV1
| This area was generated with Dilib version V0.6.33. |  |