Activities of the International Atomic Energy Agency in the Field of Cervical Cancer

Abstract

Background and context: In 2012, 560,000 women were diagnosed with cervical cancer (CXCA) worldwide and 266,000 women died of the disease: 86% of cases and 88% of deaths occurred in low- and middle-income countries (LMICs), and two thirds of the cases are locally advanced. For locally advanced CXCA the evidence-based treatment is a combination of external beam radiotherapy with chemotherapy and brachytherapy. Five-year overall survival for all stages combined ranges between 60%-69%, depending on the case-mix and the treatment modalities used. Countries with no access to radiotherapy may only offer palliative treatment to women diagnosed with locally advanced cervical cancer. Any curative attempt for these patients should include the two components of radiotherapy: concomitant radio-chemotherapy and brachytherapy. Radiotherapy is also a cost-effective treatment modality. Aim: To show the contribution and impact of the International Atomic Energy Agency (IAEA) to the improvement of results of CXCA in LMICs. Strategy/Tactics: Through its various programs, such as the Technical Cooperation programs, the Human Health program and the Program of Action for Cancer Therapy, the IAEA is committed to address these disproportionate geographic incidence and mortality rates introducing, expanding and improving radiotherapy services, working with partners such as WHO to improve cancer diagnosis, treatment, care, and control through collective action in these countries. Program/Policy process: During the last six decades, the IAEA has helped in addressing the growing cancer burden, delivering cancer-related assistance to LMICs, with financial and in-kind support from member states, donors and partners. The IAEA assistance has been primarily facilitated through the deployment of robust radiotherapy and nuclear medicine programs, coordinated research activities, documentation system and quality assurance program. This has enabled many member states to establish safe and effective diagnostic imaging and radiation therapy capacity to provide treatment and higher quality care to many of their cancer patients. The Program of Action for Cancer Therapy (PACT) is the IAEA's umbrella program for combating cancer and builds upon the above experience in radiation medicine expertise and technology. The WHO-IAEA Joint Program enable LMI member states to introduce, expand and improve their cancer treatment capacities and therapeutic effectiveness by integrating radiotherapy into a comprehensive national cancer control program. Outcomes: The IAEA provides tools for improving the practice of radiation medicine around the world. A fully implemented department (megavoltage and afterloading units, trained staff and quality assurance procedures in place) can treat up to 666 new CXCA cases per year, of which around 70% (466) can be cured. What was learned: Investing in radiotherapy can save lives!