ReviewFrontiers in nuclear medicine2026
Availability, accessibility, and economic feasibility of radionuclide therapies in Africa: a systematic review and quantitative infrastructure analysis.
Review in Frontiers in nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
1 author.
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Abstract
Purpose: Africa faces a projected doubling of cancer burden by 2040, yet access to radionuclide therapies remains critically limited. This systematic review quantifies the availability, accessibility, and economic feasibility of therapeutic nuclear medicine across 54 African nations. Methods: This study combined a PRISMA 2020-compliant systematic literature review with secondary database analysis. A comprehensive search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and African Journals Online (January 2022-March 2026). Epidemiologic and infrastructure data were additionally obtained from GLOBOCAN 2022 and the International Atomic Energy Agency (IAEA). Risk of bias was assessed using the modified Newcastle-Ottawa Scale for peer-reviewed studies and the AACODS checklist for gray literature. Results: Of 2,847 records identified, 47 studies met the inclusion criteria. I-131 therapy for thyroid cancer is available in only 28/54 countries (51.9%), while Lu-177-PSMA for prostate cancer is available in only seven countries (13.0%). Local radiopharmaceutical production reduces therapy costs by 93%-96% compared with imported agents. Africa has approximately 0.18 nuclear medicine physicians per million population vs. 3.1 in Europe. The cost reduction ratio for local vs. imported Lu-177-PSMA is 1:28.3 (US$1,500-3,000 vs. US$42,500). Conclusion: Radionuclide therapy availability in Africa is profoundly inadequate relative to disease burden. Economic modeling demonstrates that local production and regional hub models can achieve cost reductions exceeding 90%, making therapies economically feasible for resource-limited settings. Targeted investment in cyclotron infrastructure and workforce development is urgently needed.
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