The Asia-Pacific region stands at the epicenter of a mounting global health challenge, bearing approximately 60 per cent of the world's cancer deaths despite housing just over half of the global population. With cancer incidence projected to surge dramatically—needing to treat over five million radiotherapy patients annually by 2035—robust data systems are essential for effective planning, resource allocation, and equitable care delivery. Yet, critical shortcomings in oncology infrastructure threaten to exacerbate existing disparities, particularly in low- and middle-income countries (LMICs) where access to timely diagnosis and treatment remains severely limited.
A groundbreaking Australian-led study has now illuminated these vulnerabilities, providing the first comprehensive regional benchmark of oncology information systems (OIS)—digital platforms designed to manage patient data, treatment planning, and outcomes tracking in cancer care. Oncology Information Systems (OIS) integrate electronic health records specific to cancer treatment, enabling clinicians to record demographics, diagnoses, treatment details, and follow-up data in structured formats for analysis and reporting.
Unveiling the Study: A Collaborative Effort Led from Australia
Published in January 2026 in the journal Clinical Oncology, the study titled "Strengthening Oncology Data Systems for Equitable Care in Asia-Pacific: Current Practices and Future Directions" was spearheaded by researchers from The George Institute for Global Health, in close partnership with the University of New South Wales (UNSW Sydney). Lead author Dr. Vikneswary Batumalai, a Senior Research Fellow at the institute, along with senior author Associate Professor Mei Ling Yap, Head of the Cancer Program and a radiation oncologist, drew on expertise from across the region. Their work, funded by the Australian Government through the Department of Foreign Affairs and Trade, collaborated with the International Atomic Energy Agency (IAEA) and the Australian Nuclear Science and Technology Organisation (ANSTO).
The research underscores Australia's pivotal role in regional health leadership, leveraging its advanced research ecosystem to address shared challenges. UNSW Sydney's involvement highlights how Australian universities are driving international collaborations that translate into real-world health improvements.
Methodology: A Rigorous Regional Survey
To benchmark OIS capabilities, the team distributed a detailed questionnaire to 149 radiotherapy professionals working in cancer centres across 19 Asia-Pacific countries, including Cambodia, India, Indonesia, Malaysia, Mongolia, Thailand, and others spanning low-middle-income (L-MIC), upper-middle-income (U-MIC), and high-income countries (HIC). The survey probed utilisation levels—ranging from basic record-and-verify functions (like confirming treatment plans) to advanced features such as outcome tracking and integration with other systems. It also evaluated data capture completeness for demographics, diagnoses, treatments, and equity indicators (e.g., ethnicity, disadvantaged status), IT support, staff training, and linkages to national registries.
Responses were stratified by World Bank income classifications to reveal patterns. This descriptive analysis provided granular insights: for instance, structured data entry in OIS versus free-text or paper notes, and frequency of recording specific fields. The methodology's strength lies in its focus on radiotherapy departments, where linear accelerators and planning systems generate high volumes of data ripe for standardisation.View the study abstract on PubMed
Persistent Reliance on Paper Records in LMICs
One of the most alarming revelations: more than half of cancer centres in L-MICs continue to rely on paper records for critical treatment information, hampering real-time access, error reduction, and analytics. Even where OIS exist, utilisation is superficial—only 34 per cent in L-MICs and 59 per cent in U-MICs extend beyond basic functions like plan verification to sophisticated modules for toxicity tracking or long-term survival data.
- In L-MICs, basic demographics like date of birth (83 per cent captured) and sex (98 per cent) are routine, but advanced fields lag.
- U-MICs show slightly better uptake, yet paper persists for complex entries.
- HICs demonstrate near-universal advanced OIS use, with 80-90 per cent structured capture across categories.
This digital divide mirrors broader infrastructure gaps, where LMICs face equipment shortages and power instability, underscoring the need for resilient, low-cost solutions tailored to resource constraints.
Data Gaps Fueling Inequities and Poor Planning
Equity data—vital for identifying underserved groups—is woefully inadequate. In 78 per cent of L-MIC centres, disadvantaged population status is rarely or never recorded, obscuring disparities in access for rural, indigenous, or low-socioeconomic patients. Ethnicity capture fares better in HICs (59 per cent) but drops sharply elsewhere (48 per cent U-MIC). Alarmingly, almost no LMIC centres link OIS to national cancer registries, preventing population-level surveillance and trend analysis.
Diagnosis and staging data show variability: while treatment sites (84-98 per cent across groups) and modalities (86-95 per cent) are well-documented, intent (curative vs. palliative, 77-90 per cent) and outcomes are inconsistent. Dr Batumalai emphasised, "We can't fix what we can't measure," highlighting how these voids blind health systems to inequities.Explore research opportunities in global health data systems.
Photo by International Student Navigator Australia on Unsplash
Bright Spots: Robust Radiotherapy Data Foundations
Not all news is grim. Radiotherapy data—encompassing dose, fractions, and sites—emerges as a consistency beacon, captured in 84-98 per cent of centres regardless of income level. This reflects radiotherapy's standardised workflows, supported by treatment planning systems (TPS) that interface with OIS.
In HICs, 50 per cent enter such data into structured OIS fields, versus 35 per cent in LMICs. This foundation positions radiotherapy as a scalable entry point for broader digitisation: by expanding OIS to include chemotherapy, surgery, and survivorship data, centres can build holistic electronic health records (EHRs).
Australia's Universities Spearheading Global Solutions
UNSW Sydney's affiliation with The George Institute exemplifies Australian higher education's global impact. A/Prof Yap noted, "Australia has a key role to play in strengthening cancer control across our neighbouring countries." This project builds on prior efforts, like regional workshops with IAEA, fostering knowledge transfer in data standards and training.
Other Australian institutions contribute: La Trobe University researches cancer rehabilitation access, while University of Sydney advances cosmic dust and heart regeneration studies with oncology overlaps.Research assistant roles in oncology at Australian universities offer pathways for early-career academics to engage in such impactful work. For career guidance, check how to excel as a research assistant in Australia.
Broader Implications: From Equity to AI Readiness
Fragmented data perpetuates care disparities: LMICs, hosting rising caseloads (e.g., India and Indonesia projected 71 per cent colorectal cancer increase by 2040), struggle with planning amid untracked outcomes. Without equity metrics, interventions bypass vulnerable groups. Moreover, poor data quality stalls AI adoption—machine learning for predictive analytics requires clean, standardised inputs absent here.
A/Prof Yap added, "Reliable data is the foundation for emerging technologies like AI-supported cancer care." Bridging gaps could optimise resource use, as APAC faces over 9.8 million new cases yearly, with workplace support increasingly critical.Read the full George Institute release.
Actionable Recommendations for Systemic Change
- Prioritise comprehensive staff training on OIS advanced features and data governance.
- Develop a regionally endorsed minimum dataset, harmonising fields like equity indicators and outcomes.
- Invest in infrastructure: cloud-based OIS for LMICs to bypass hardware limits.
- Foster integrations with national registries and EHRs for seamless data flow.
- Leverage partnerships like IAEA-ANSTO for technology transfer and capacity building.
The study reveals centres' eagerness for improvement, with tailored programs poised to accelerate progress. Australian academics can lead via grants and collaborations.
Future Outlook: Projections Demand Urgent Reform
By 2035, APAC radiotherapy demand will exceed five million patients annually, amid global trends of 35 million new cases by 2050 (77 per cent rise). Breast cancer cases may climb 38 per cent by 2050, hitting LMICs hardest. Without data upgrades, survival gaps widen—LMICs at 25-45 per cent five-year rates versus 65-85 per cent in HICs.
Optimism lies in scalable models: hub-and-spoke networks and AI pilots. Australian universities, via professor roles in global health, can pioneer these.
Career Opportunities in Oncology Research
This study spotlights demand for data scientists, epidemiologists, and radiation oncologists in APAC-focused research. Australian higher ed offers platforms: UNSW's global health programs train experts addressing these gaps. Aspiring researchers, visit higher-ed jobs, rate my professor, and career advice for entry points. Postdocs thrive via postdoc opportunities.
In summary, the UNSW-led benchmark galvanises action, positioning Australian academia as a beacon for equitable cancer care across Asia-Pacific. With investment and collaboration, closing these gaps is achievable.
