Vergara Thomas Vincent T, Chua Timothy Micah C, Santi Katrina Marie G, Magsanoc Juan Martin J, Peña-Camacho Angela, Vega Gaudencio P, Calaguas Miriam Joy C
Department of Radiation Oncology, St. Luke's Medical Center - Global City, Taguig City, Philippines.
Adv Radiat Oncol. 2023 Aug 15;9(2):101354. doi: 10.1016/j.adro.2023.101354. eCollection 2024 Feb.
As global cancer incidence continues to rise, low- to middle-income countries like the Philippines are projected to experience a disproportionate increase in cancer burden, further straining already limited resources. Radiation therapy (RT) is an essential and cost-effective modality in cancer care, both in the curative and palliative settings. In this article, we provide a brief narrative on the history of the field of radiation oncology in the Philippines and review the current challenges to effective and equitable RT service delivery in the country.
We gathered data from the official websites of the Philippine government's health and statistics agencies, the Philippine Radiation Oncology Society, and the Directory of Radiotherapy Centers of the International Atomic Energy Agency, to review available human and infrastructure resources related to RT delivery in the country. Using the 6 health care dimensions of the World Health Organization's Building Blocks of Health Systems framework, we identified barriers to access and proposed possible initiatives for development.
Despite the remarkable growth of radiation oncology in the country in the past 2 decades, many challenges remain in the areas of human resources, infrastructure, policymaking, health economics, education, and service delivery. Radiation health workers and facilities are concentrated in the National Capital Region, limiting accessibility in rural areas. Out-of-pocket spending on RT-related expenditures remains high. The proper allocation of resources according to varying regional needs is impeded by the lack of a robust national cancer registry. Legislative reforms have been initiated but have yet to be fully implemented.
Addressing these gaps in RT access will require in-depth study and multi-sectoral commitment aimed at establishing and implementing a nationwide framework for RT service delivery that can be readily adapted to varying regional needs. Despite many complex geographic, social, and economic obstacles, efforts by private and public sectors of society to provide ready access to RT services for all Filipinos continue to gain momentum.
随着全球癌症发病率持续上升，预计像菲律宾这样的低收入和中等收入国家的癌症负担将出现不成比例的增长，这将进一步给本就有限的资源带来压力。放射治疗（RT）在癌症治疗中，无论是根治性还是姑息性治疗环境下，都是一种必不可少且具有成本效益的治疗方式。在本文中，我们简要叙述了菲律宾放射肿瘤学领域的历史，并审视了该国在有效且公平地提供放射治疗服务方面当前面临的挑战。
我们从菲律宾政府卫生和统计机构、菲律宾放射肿瘤学会以及国际原子能机构放射治疗中心名录的官方网站收集数据，以审查该国与放射治疗服务提供相关的人力和基础设施资源。利用世界卫生组织卫生系统构建模块框架的六个卫生保健维度，我们确定了获取服务的障碍，并提出了可能的发展举措。
尽管在过去20年里该国放射肿瘤学有显著发展，但在人力资源、基础设施、政策制定、卫生经济学、教育和服务提供等领域仍存在许多挑战。放射卫生工作者和设施集中在国家首都地区，限制了农村地区的可及性。与放射治疗相关支出的自付费用仍然很高。缺乏完善的国家癌症登记系统阻碍了根据不同地区需求进行资源的合理分配。立法改革已经启动，但尚未全面实施。
解决放射治疗可及性方面的这些差距需要深入研究和多部门的承诺，旨在建立并实施一个可根据不同地区需求轻松调整的全国性放射治疗服务提供框架。尽管存在许多复杂的地理、社会和经济障碍，但社会私营和公共部门为所有菲律宾人提供便捷放射治疗服务的努力仍在不断推进。
