Proton Therapy in Canada: Toward Universal Access and Health Equity With a Publicly Funded Facility

Abstract

Proton beam therapy (PBT) is utilized worldwide in the treatment of pediatric cancers and many cancers in adults as accumulating clinical evidence indicates dosimetric and toxicity advantages. However, Canada is the only G8 country without an operating clinical PBT facility. Access to out-of-country PBT referrals, adjudicated by individual provincial governments, varies across the country. The lack of domestic capacity for PBT, variability in public funding nationwide, and the anticipated future demand for PBT suggest unmet needs for health equity in Canadian cancer care. This article outlines the current state of access to PBT across Canadian provinces, domains of health inequities among those receiving PBT, and strategies for addressing health inequity in PBT, in the context of ongoing planning for a Canadian publicly funded facility. The lessons learned from the Canadian experience may be applicable to other jurisdictions seeking to improve fair, equitable access to PBT.