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. 2025 Apr 11;6(4):425-431.
doi: 10.1302/2633-1462.64.BJO-2024-0208.R1.

Global and regional disparities in access to specialist sarcoma services

Tomas Zamora  1 , Eduardo Botello  1 , Thomas Jenkins  2 , Charlotte Jeys  2 , Minna Laitinen  3 , Ajay Puri  4 , Lee Jeys  5 ; BOOM consensus meeting participants
Collaborators, Affiliations

Global and regional disparities in access to specialist sarcoma services

Tomas Zamora et al. Bone Jt Open. .

Abstract

Aims: Cancer care guidelines have been developed in many subspecialities, usually in advanced health systems. However, there are notable global disparities in healthcare access, which can impact sarcoma care. Unfortunately, there is a lack of global data on this subject. Our aim was to describe access to sarcoma care based on a comprehensive global survey among orthopaedic oncologists, and assess for global as well as regional differences.

Methods: A 25-question survey was emailed to the attendees of the 2024 Birmingham Orthopaedic Oncology Meeting and included questions about the respondents' training and practice, access to sarcoma centres, and specific items for sarcoma diagnosis and treatment. For data analysis and comparison, countries were grouped geographically and per the World Bank's income classification.

Results: A total of 192 specialists from 47 countries completed the survey (67%). Overall, 40% declared that most patients in their country were treated in a specialized sarcoma centre. Declared access to specific diagnostic technology ranged from 69% (translocation studies) to 86% (various immunohistochemistry). Only 31% stated having access to proton therapy and 82% to all possible reconstruction methods. Compromise of ideal surgical management because of prior treatments and financial constraints was declared to have happened regularly in 40% and 17% of practices, respectively. Regions with better-developed healthcare systems had improved access to all aspects surveyed. Similar results were observed when comparing high-income countries against low- to middle-income countries.

Conclusion: Our study highlights substantial global and regional disparities in access to sarcoma services, which could potentially impact clinical outcomes. Further studies are needed to clarify this reality.

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Conflict of interest statement

E. Botello is a board member of ISOLS and SLATME. L. Jeys reports royalties or licenses and support for attending meetings and/or travel from Implantcast, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Zimmer Biomet, Implantcast, and Stryker, all of which are unrelated to this study. L. Jeys also holds leadership or fiduciary roles in EMSOS and ISOLS. M. Laitinen reports support for attending meetings and/or travel from Tree-Step, unrelated to this study. A. Puri is on the editorial board of The Bone & Joint Journal, Bone & Joint Open, Bone & Joint 360, the Sarcoma International Advisory Board, and APMSTS. T. Zamora is a member of the SICOT Tumors subspecialty committee.

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