Assessing Equity of Access to Proton Beam Therapy: A Literature Review

Simona Gaito, Marianne Aznar, Neil Burnet, Adrian Crellin, A France, D J Indelicato, Karen Kirkby, S Pan, Gillian Whitfield, E Smith

Research output: Contribution to journalArticlepeer-review

Abstract

Proton beam therapy (PBT) is one of the most advanced radiotherapy technologies, with growing evidence to support its use in specific clinical scenarios and exponential growth of demand and capacity worldwide over the past few decades. However, geographical inequalities persist in the distribution of PBT centres, which translate into variations in access and use of this technology. The aim of this work was to look at the factors that contribute to these inequalities, to help raise awareness among stakeholders, governments and policy makers. A literature search was conducted using the Population, Intervention, Comparison, Outcomes (PICO) criteria. The same search strategy was run in Embase and Medline and identified 242 records, which were screened for manual review. Of these, 24 were deemed relevant and were included in this analysis. Most of the 24 publications included in this review originated from the USA (22/24) and involved paediatric patients, teenagers and young adults (61% for children and/or teenagers and young adults versus 39% for adults). The most reported indicator of disparity was socioeconomic status (16/24), followed by geographical location (13/24). All the studies evaluated in this review showed disparities in the access to PBT. As paediatric patients make up a significant proportion of the PBT-eligible patients, equity of access to PBT also raises ethical considerations. Therefore, further research is needed into the equity of access to PBT to reduce the care gap.

Original languageEnglish
Pages (from-to)e528-e536
JournalClinical oncology (Royal College of Radiologists (Great Britain))
Volume35
Issue number9
Early online date30 May 2023
DOIs
Publication statusPublished - Sept 2023

Keywords

  • Adolescent
  • Young Adult
  • Humans
  • Child
  • Proton Therapy
  • Radiation Oncology
  • Social Class
  • Health Services Accessibility
  • Close the gare cap
  • Equity of access
  • Democratisation of proton therapy
  • Health economics
  • Radiotherapy for all
  • Health disparities

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