{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T02:42:47Z","timestamp":1783046567341,"version":"3.54.6"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n This study aims to estimate the carbon footprint associated with external beam radiotherapy in a low\u2010 and middle\u2010income country (LMIC) context, specifically at the Uganda Cancer Institute (UCI), and to evaluate whether sustainability should be a priority alongside treatment access in such radiation therapy settings.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n A carbon footprint analysis was conducted for patients treated for locally advanced cervical cancer at UCI between 2023 and 2024. The assessment included emissions from three key components: (1) patient travel to and from the facility, (2) pre\u2010treatment imaging using CT and 2D simulation and (3) energy consumption by three Varian TrueBeam linear accelerators during treatment and idle times. Emission estimates were calculated using activity data and standard global warming potential (GWP) conversion factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Patient travel emerged as a major contributor to carbon emissions due to the centralisation of services in Kampala and the lack of regional treatment centres. Energy use from LINACs and imaging contributed less significantly, owing in part to Uganda's low\u2010carbon electricity grid powered largely by hydropower. CT scans generated approximately 0.105\u2009kg CO\n 2<\/jats:sub>\n per scan, and LINAC operations added modest emissions depending on usage patterns and machine idle time.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n While radiotherapy\u2010related emissions in LMICs like Uganda are relatively modest compared to high\u2010income countries, they are non\u2010negligible and expected to rise with growing access to cancer care. Incorporating sustainability considerations into the future planning of radiotherapy infrastructure and service expansion is both feasible and necessary. Carbon\u2010conscious planning should be integrated into decisions around siting and radiotherapy expansion to promote environmentally responsible cancer care in LMICs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1754-9485.70083","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:10:58Z","timestamp":1773457858000},"page":"395-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating the Carbon Footprint of External Beam Radiotherapy: Should This Be a Concern for\n LMICs<\/scp>\n ?"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3550-8894","authenticated-orcid":false,"given":"Afua A.","family":"Yorke","sequence":"first","affiliation":[{"name":"University of Washington Fred Hutch Cancer Center Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komakech","family":"Ignatius","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute Kampal Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Oncology and Physics, Engineering Physics & Astronomy Queen's University Kingston Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5189-4046","authenticated-orcid":false,"given":"Tomas","family":"Kron","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Australia"},{"name":"Centre for Medical Radiation Physics University of Wollongong Wollongong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2021.12.018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2023.102652"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2022.101170"},{"key":"e_1_2_8_5_1","unstructured":"T. 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