Radiation Oncology in the Developing Economies of Central and Eastern Europe

Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing. The level of health financing available through health insurance has increased in the region, although still lags behind the Western European levels. After adjusting for differing population age structures, overall incidence rates in both sexes are lower in Eastern and Central Europe compared with the Northern and Western European countries; however, mortality remains higher. There is an ongoing shortage of oncology services in Eastern Europe, including radiotherapy equipment and personnel. Eastern European radiotherapy field is highly diverse with large differences among countries regarding staffing structure, training, accreditation, and defined roles and responsibilities. The rapid diffusion of technological innovations has been identified as one of the most important factors driving the escalating health care expenses, and the need for better cost-effective solutions applicable to the local health care systems and levels of economic development.