Global Efforts to Reduce Paediatric Cancer Care Disparities in Radiotherapy: A Decade Change.

BACKGROUND: We present an update on the status, needs and challenges faced by paediatric imaging and radiotherapy (RT) programmes globally after a previous survey conducted by the International Atomic Energy Agency (IAEA) 10 years prior. METHODS: We developed and distributed a 121-question survey to radiation oncologists, medical physicists and radiologists from participating Member States (MSs). It included questions on radiation oncology, imaging, nutrition, human capacity to support these services, quality assurance practices and other aspects of childhood cancer management. Questions evaluated practices, access, standards and other topics specific to childhood cancer care. RESULTS: Forty-seven IAEA MSs completed the survey. Regardless of country income level, most institutions had departments providing essential services of paediatric oncology, anaesthesia and radiology. Disparities in access exist regarding nuclear medicine, advanced diagnostic and interventional radiology, linear accelerators, quality assurance and services for patients and families favouring higher-income countries. Medical physics presence for radiation oncology was consistent across income level, whereas access to it was scarce. Regarding diagnostic imaging, most respondents reported access to computed tomography but access to other advanced imaging technologies was limited. CONCLUSIONS: While there have been improvements in access to certain aspects of paediatric cancer care compared to the previous survey, disparities persist, particularly in low- and middle-income countries. There is a need for more specialized training, better access to imaging and RT technology, and improved ancillary services. These findings can inform policy and decision-making authorities towards the WHO's 2030 goal for childhood cancer.