# Radiotherapy for everyone who needs it by 2040

Source: https://onco.cc/ideas/idea-moon-radiotherapy-for-everyone-2040/  
OnCo record `idea-moon-radiotherapy-for-everyone-2040` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Half of cancer patients need radiotherapy and most of the world cannot get it. Commit to low-cost machines, automated planning and trained staff so that access is universal by 2040.

## Summary

The Lancet Oncology Commission estimated enormous unmet radiotherapy need in low- and middle-income countries, with many countries having no machine at all. Barriers are capital cost, maintenance, physics and oncologist workforce, and planning complexity. The proposal is a coordinated programme: purpose-designed low-cost, low-maintenance linear accelerators for harsh environments (the CERN-STFC-ICEC effort), AI-automated contouring and planning with remote quality assurance, task-shifted training curricula, and pooled procurement and financing through IAEA Rays of Hope and development banks, with a public dashboard of machines per million and treatment gap by country.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: The programme halves the global radiotherapy treatment gap by 2035 and closes it in participating countries by 2040, with survival gains in cervical, head and neck and breast cancers measurable in registries.
- Rationale: Radiotherapy is curative, cost-effective and needed in half of all patients; the constraints are engineering, finance and workforce, all of which have been solved for other technologies at scale.
- Proposed test: Deploy ruggedised machines with automated planning and remote QA in ten centres in five countries; measure uptime, throughput, plan quality against expert review and cost per course.
- Maturity: early-clinical
- Actor: policy

## Sources

- IAEA Rays of Hope: https://www.iaea.org/services/rays-of-hope

## Connected records

- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/)
- technologies: [Brachytherapy](https://onco.cc/technologies/brachytherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/)
- companies: [Elekta](https://onco.cc/companies/elekta/), [Varian (Siemens Healthineers)](https://onco.cc/companies/varian/)
- institutions: [International Agency for Research on Cancer (IARC / WHO)](https://onco.cc/institutions/iarc/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)

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