Radiation Therapy Utilization and Capacity

Bottom-Line

Radiation use is fairly stable across the provinces while capacity varies across provinces for 2007-2010

What are we measuring?

This indicator measures the percentage of incident cases that receive radiation therapy for any reason within two years of diagnosis. Radiation utilization rates are compared by province for the 2010 diagnosis year. Also presented is the capacity of radiation therapy services by province. Capacity is measured as the number of linear accelerators per million people.

• Along with surgery and systemic therapy, radiation therapy forms part of the backbone of cancer treatment services. A patient may receive radiation therapy pre-operatively (neo-adjuvant), post-operatively (adjuvant) or alone without surgery or other treatments, or in combination with chemotherapy (chemo-radiation).¹
• Ensuring access to radiation therapy services for all cancer patients who need it is a critical priority in cancer treatment service planning. Relatively low radiation therapy utilization rates in a province, coupled with relatively low linear accelerator capacity, may indicate potential access limitations.

What are the results?

• Radiation therapy use varied only slightly by province for the 2010 diagnosis year. Rates of radiation therapy use within two years of diagnosis ranged from 29.1% to 35.9% in 2010 (Figure 4.12). Generally, rates remained fairly stable between 2007 and 2010.²
• The average number of linear accelerators per capita in Canada has increased over the four-year timeframe. In 2012, the number ranged from 4.5 per million people in Alberta to 13.8 per million in Prince Edward Island, with a Canadian average of 7.2 per million (Figure 4.13).

What do the results mean?

• While the majority of provinces reported consistent radiation therapy utilization rates from 2007 to 2010, notable changes occurred in Prince Edward Island from 2009 to 2010 as a result of the addition of a second linear accelerator in the province.²
• The more commonly cited international benchmark for radiation therapy use in cancer examines radiation therapy over the lifetime of patients.^3,4 Since this method has been developed and validated elsewhere,⁵ there are plans in place to develop a methodology for calculating a (modelled) lifetime utilization rate. The results will then be reported in future system performance reports so that comparisons can be made to the international benchmarks. This use will include all treatment intents, including second- and third-line therapy as well as symptom management.

References

1. National Cancer Institute. Radiation therapy for cancer. NCI; 2010 [cited Oct 30, 2012]. Available from: www.cancer.gov/cancertopics/factsheet/Therapy/radiation
2.  Canadian Partnership Against Cancer. The 2012 cancer system performance report. Toronto: The Partnership; 2012.
3. Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment. Cancer. 2005;104:1129-37.
4. Newman L. Australian report urges nationwide radiation therapy plan. J Nat Cancer Inst. 2001;93:1516-7.
5. Zhang-Salomons J, Mackillop WJ. Estimating the lifetime utilization rate of radiotherapy in cancer patients: the multicohort current utilization table (MCUT) method. Comput Methods Programs Biomed. 2008;92:99-108.