Radiotherapy needs in French-speaking low- and middle-income countries: Overcoming language barriers for equitable...

Cancer impacts populations in low- and middle-income countries disproportionately, where resources are limited, and cancer often diagnosed at more advanced stages. Radiotherapy plays a crucial role in treatment of cancer. However, language barriers often hinder partnerships and training with certain low- and middle-income countries, as most scientific societies primarily operate in English. This project aimed to evaluate the current, projected needs and gaps in radiotherapy specific to French-speaking low- and middle-income countries.

An infrastructure database of 89 French-speaking countries was compiled, including countries associated with the Organisation internationale de la francophonie. Cross-referencing with World Bank income groups identified French-speaking low- and middle-income countries. Available radiotherapy infrastructures were obtained from the International Atomic Energy Agency. Projections for cancer cases and radiation therapy needs were made for 2030 and 2040.

Thirty-five countries were identified as French-speaking low- and middle-income countries. Projected cancer burden is expected to increase by 44.7 % between 2020 and 2040. Assuming a conservative 50 % of patients benefit from radiotherapy, demand for treatment units will increase of 34.8 % between 2020 and 2040. The average number of radiotherapy units per 1000 cases remained low at 1.0 among countries with radiotherapy; significantly below the targeted two units per 1000 cases. Fourteen French-speaking low- and middle-income countries had no radiation capacity.

French-speaking low- and middle-income countries have a significant shortage of radiotherapy infrastructure for the increasing cancer demand. Limited language diversity in educational resources poses a barrier to radiotherapy access in these settings. This linguistic barrier may exacerbate workforce shortages in radiotherapy. Global initiatives should prioritize language considerations when strategizing efforts and allocating resources. High-income French-speaking nations are strategically well placed to cultivate collaborative networks essential for the advancement of these initiatives.