Radiotherapy utilization at the fourth most populous province in Indonesia: A single centre study.

Abstract

1606 Background: Cancer continues to grow as a health burden in Indonesia, with the current cumulative cancer risk at 14.0%. Along with the rising rate of cancer discovery, treatment effectiveness should be constantly improved. This study was conducted to explore the actual radiotherapy utilization rate (aRUR) of the 10 most common cancers at Murni Teguh Memorial Hospital (MTMH), a cancer referral hospital in North Sumatra. Methods: This was a retrospective study utilizing MTMH medical records in 2019. Data on the 10 most common cancers in Indonesia (based on GLOBOCAN 2020) were collected. Completed data underwent double filtering and cleaning before analysis with the Statistical Package for the Social Sciences (SPSS) and Microsoft Excel to calculate aRUR. Further elaboration was made to compare with the Collaboration for Cancer Outcomes Research and Evaluation (CCORE) RUR data. Results: A total of 3,928 samples were collected with 74% of patients being female; the mean age is 50 (0,6 to 96) years old; 38% of cancer staging reported (6% stage I; 32% stage II; 34% stage III; and 28% stage IV). The most to least common cancers are breast, colon, rectal, nasopharynx, cervix, ovary, leukemia, prostate, lung, and lymphoma. Out of 457 irradiated cases, radiotherapy was most used in breast (36%), nasopharyngeal (23%), and cervical cancer (23%). There was gap between these three cancers' aRUR to their optimal RUR (oRUR) calculated by CCORE (54.4% for cervix; 52% for nasopharynx; 41.27% for rectum). Optimal radiotherapy utilization was reached only for colon and ovarian cancers. Conclusions: Our study shows that a gap between aRUR and oRUR was observed for most cancers treated at MTMH. Several factors may contributed to this result, including patient factors, clinical factors, and administrative/bureaucracy factors. Further study is needed to address the cause and to plan any measures to shorten the gap and optimize radiotherapy.