The Second Central Asian Radio оncological Congress CARO-2019, held on 27-29 September 2019 in the Republic of Uzbekistan, gathered 106 participants. At its sessions, 50 reports were heard and issues of improving cancer services, system organization of cancer institutions, best clinical practices and the latest technological solutions in the field of radio oncology were discussed. Due to the large number of reports, the development of medical physics and nuclear medicine, as well as targeted training of radio-oncology personnel, were highlighted in separate sections. An important role in ensuring the high professionalism of the Congress was played by the large-scale participation of German specialists, who presented 19 reports.

According to the results of CARO-2019, the expert community of specialists in the field of radio-oncology of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, as well as Germany, Russia, Belarus, Turkey, representatives of leading manufacturers of equipment in the field of radiation diagnostics and therapy states the following.

State activity and private initiative in the development of high-tech means of detection and treatment of cancer is growing in Central Asia. The region is increasingly recognized as a real and promising market in the field of radio oncology by both manufacturers of modern technological complexes and carriers of clinical experience.

As a result of the first CARO-2018 Congress, accompanying its publications in the press, the exchange of information within the medical community, public and private medical subjects became an “explosive” interest in the possibilities of effective treatment of cancer with radiation therapy by the highest state authorities, the generation of large-scale business projects in this field. However, with the understanding of the technological and clinical complexity of radiotherapy, the intention to accelerate the implementation of such projects has been replaced by more cautious approaches based on the need for comprehensive, consistent solutions.

Within the framework of country management in health care in the region, a systematic experience of national cancer control strategies is being formed at a high state level. In particular, the Government of Kazakhstan has adopted and is implementing a comprehensive cancer control plan for 2018-2024, and the President of Uzbekistan has approved a set of measures to develop cancer services and improve cancer care for the population for 2017-2021.

Following Kazakhstan, where in 2010-2015 a basic park of 12 modern linear accelerators was formed in its cancer centers, and in 2018-2019 a new program of installation of 10 more accelerators until 2024 was launched, an important practical step was taken in Uzbekistan, where in 2018-2019 in Tashkent in the Republican and city oncology centers two high-energy linear accelerators were installed and launched into the treatment process. Kyrgyzstan also signed a contract for the supply and launch of two linear accelerators at the National Center for Oncology and Hematology in 2020.

At the national level, the need has been recognized and the process of formation of holistic projects of modern oncology institutions, implemented on the basis of advanced foreign clinical competence and international standards, has been launched. Such projects include the German Oncology Clinic in Uzbekistan, which is being established on the basis of the competence of the University Clinic of Freiburg and OPASCA German Oncology Solutions (Germany), the new National Scientific Cancer Center of Kazakhstan, which is the competence of the Medical Center of the University of Pittsburgh (USA) and the Vinci Construction Grands Project (France), and the Center for Nuclear Medicine and Radiation Therapy at the Institute of Nuclear Medicine of the Academy of Sciences of the Republic of Uzbekistan, which is the competence of Integra and Vamed (Germany). In Turkmenistan, a new bicycle cancer hospital in Dashoguz is being designed at the current level.

The development of modern radionuclide diagnostics capabilities in the countries of the regions, in particular PET scans, which enable early detection of cancers, is of great importance. Private clinics are active in the field of nuclear medicine in Kazakhstan and Uzbekistan: the Sunkar Oncology Centre in Almaty, the “Ymit” Centre for Toma Therapy and Nuclear Medicine in Nur-Sultan (Astana), the New Life Medical PET centres in Tashkent and the Clinical Sanatorium named after Fedorovich in Tashkent.

The medical efficiency of high-tech radio-oncological equipment is limited by the fact that manufacturing companies, providing technical tools, do not set the task and do not ensure the transfer of clinical competence. This is the reason for the deadlock in the purchase of high-tech “iron” with short-term briefings from manufacturers without investing in the full training of personnel, defined, in particular, by IAEA standards.

There is no satisfactory verification of the professions of “medical physicist” and “radiological technician/nurse-radiologist” in the region, and there is no system of higher and professional education in these specialties that meets international standards, in particular, IAEA recommendations. Accordingly, full training of relevant personnel can be carried out mainly at foreign sites. An example of this is the successful training of medical physicists for private clinics in Uzbekistan at Moscow State University in 2019.

Installation of high-tech radio-oncological equipment in the countries of the region requires the development and implementation of information systems for clinical process management and follow-up of oncological patients, the lack of which today causes difficulties in the storage and transfer of patient radiological data, the integration of local clinical systems of public and private medical institutions into the unified system of state level.

The establishment of a public-private partnership and the introduction of unified mechanisms for paying for public and private clinics on a “for the treated case” basis, the first experience of which is being formed in Kazakhstan, Kyrgyzstan and Uzbekistan, are of prospective importance for the development of radio-oncological services to the population.