Prescription of Cancer Treatment Modalities in Developing Countries: Results from a Multi-Centre Observational Study

Rolando Camacho^1*, Diogo Neves¹, Marion Piñeros¹, Eduardo Rosenblatt¹, Robert Burton², Yaima Galán³, Feras Hawari⁴, Saadettin Kilickap⁵, Cláudia Naylor⁶, Florian Nicula⁷, Jesus Reno⁸, Bhawna Sirohi⁹, Tatiana Vidaurre¹⁰, Kazem Zendehdel¹¹

¹International Atomic Energy Agency, Vienna, Austria.
²Monash University, Melbourne, Australia.
³Ministry of Health, La Habana, Cuba.
⁴King Hussein Cancer Centre, Amman, Jordan.
⁵Hacettepe University Oncology Centre, Ankara, Turkey.
⁶National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil.
⁷Institute of Oncology Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania.
⁸National Institute of Oncology and Radiobiology, La Habana, Cuba.
⁹Tata Memorial Hospital, Mumbai, India.
¹⁰National Institute of Neoplastic Diseases, Lima, Peru.
¹¹Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

DOI: 10.4236/jct.2014.511103                

Abstract

Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer spe-cific treatment planned and written in the patients’ medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.

Keywords

Cancer Treatment, Developing Countries, Health Services Needs and Demand, Resource Allocation, Observational Study

Conflicts of Interest

The authors declare no conflicts of interest.

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