Radiotherapy travel times - is time running out in India?

Abstract

Inequitable radiotherapy availability in India leads to non-compliance in many cases, as patients need to travel long distances for treatment; this has long-term implications for achieving the United Nations sustainable development goals. Notably, the number of functional radiotherapy units in India is below the limit recommended by the World Health Organization, and most centers in this vast country are located in urban centers. This creates a serious barrier to accessibility for the socioeconomically disadvantaged sections of the rural population. Recent reports suggest that despite the availability of free treatments for a wide variety of cancers, many patients are non-compliant owing to the high costs incurred on travel to distant centers. In view of the current distribution of radiotherapy units, and the low ratio of radiotherapy units serving the vast population, distances traveled for radiotherapy are likely to have considerable impact on realization of the United Nations sustainable development goals. It is also likely to have considerable impact on the existing weak infrastructure of healthcare facilities, as poor cancer control will increase the need for palliative care and support, thereby further reducing resource allocation to cancer control. Policies directed towards reducing travel times for radiotherapy are currently lacking in India. However, this issue needs urgent consideration to ensure optimal utilization of available resources. Until measures to reduce travel time can be implemented, reducing travel-related patient distress may improve compliance in the short term; urgent measures in this regard will help achieve the targets of the United Nations sustainable development goals.