A recent study by the Indian Council of Medical Research (ICMR) has revealed a major shortfall in radiotherapy utilisation for cancer treatment across India. Published in the BMC Cancer journal, the study found that only 28.5% of cancer patients currently receive radiotherapy—well below the optimal rate of 58.4% based on clinical guidelines. This gap underscores an urgent need to scale up radiotherapy infrastructure to provide equitable cancer care.
Cancer Types Driving Radiotherapy Demand
As reported by theweek, the study highlighted that four cancer types—breast, head and neck, lung, and cervical—constitute nearly 60% of India’s total radiotherapy demand. Notably, the relative deficit in radiotherapy use is most severe in lymphoma and lung cancers, exceeding 70%, followed by significant gaps in prostate, breast, and oesophageal cancers.
Methodology and Data Sources
Researchers from the ICMR-National Centre for Disease Informatics and Research (NCDIR), Bengaluru, conducted the study using epidemiological data from the National Cancer Registry Programme (NCRP). They also incorporated modelling data from the Australian Collaboration for Cancer Outcomes Research and Evaluation (CCORE) to calculate optimal radiotherapy fractions and estimate machine requirements.
Radiotherapy Machine Deficit
The findings reveal a critical shortage of radiotherapy machines in India. For the country’s projected 2025 population of 1.45 billion, the WHO recommends a minimum of one machine per million population—translating to at least 1,450 machines. However, India currently has only 794 megavoltage (MV) machines, reflecting a shortfall of approximately 45% from the minimum benchmark. Based on clinical indications and benchmarks, the country would actually need between 1,585 to 2,545 machines—and up to 2,291 machines if previous global estimates are applied.
Future Cancer Burden in LMICs
The report warns of an expected 70–100% rise in breast, head and neck, and lung cancer cases in low- and middle-income countries (LMICs) like India. With cancer already ranking as the fifth leading cause of death in India and accounting for 7% of the global cancer burden, the healthcare system faces mounting pressure to expand radiotherapy services.
Urgent Call for Policy and Investment
The study calls for substantial investment in radiotherapy infrastructure, especially in underserved regions. It also emphasizes the need for equitable distribution of machines and the development of cost-effective indigenous equipment to reduce reliance on expensive imports.
Way Forward: Planning, Detection, and Equity
The researchers urge a comprehensive situational analysis of current radiation equipment, including deployment, throughput, and utilisation rates, to inform national planning and policy. They also stress the importance of early cancer detection and screening programmes, which can lead to earlier diagnosis, lower radiotherapy demand, and improved patient survival outcomes.
Conclusion
With the projected cancer incidence expected to reach 1.57 million cases in India by 2025, the study underscores the critical role of radiotherapy in cancer treatment and the need for immediate action. Evidence-based planning, increased investment, and a focus on equitable access are essential to bridge the current gap and ensure effective cancer care delivery nationwide.