{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:22:24Z","timestamp":1792027344231,"version":"4.4.0"},"reference-count":22,"publisher":"BMJ","funder":[{"name":"Wellcome Senior Research Fellowship","award":["207472"],"award-info":[{"award-number":["207472"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,7,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/aims<\/jats:title>\n                    <jats:p>To assess the global availability of retinoblastoma (Rb) diagnostic and treatment services in 2024 and examine changes in their income-related distribution since 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an international cross-sectional study with a longitudinal comparison. In 2024, 438 Rb treatment centres from 145 countries participated; 49 countries had no identified Rb centres, and four were unconfirmed. Longitudinal analyses included 246 centres from 124 countries that participated in both the 2017 and 2024 assessments. Centres reported availability of key diagnostic services (CT, MRI, pathology and genetic testing) and treatment modalities (intravenous, intravitreal and intra-arterial chemotherapy; focal therapies and radiotherapy). Service availability was assessed using country-level binary availability and proportional availability across centres. Income-related distribution was evaluated using concentration curves and concentration indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2024, pathology services were available in 143 of 145 countries (98.6%), MRI in 128 (88.3%) and genetic testing in 74 (51.0%). Intravenous chemotherapy was available in 139 countries (95.9%), intravitreal chemotherapy in 101 (69.7%) and intra-arterial chemotherapy in 69 (47.6%). Among centres participating in both study years, proportional availability increased across all modalities between 2017 and 2024, with the largest gains observed for genetic testing, intravitreal chemotherapy and cryotherapy. Except for pathology and intravenous chemotherapy, service availability remained concentrated in higher-income settings. Sensitivity analyses indicated that observed reductions in income-related inequality were not explained by income reclassification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Between 2017 and 2024, global availability of Rb services increased and income-related inequality narrowed. However, advanced diagnostic and eye-preserving treatments remain predominantly available in higher-income settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2026-329476","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:20:25Z","timestamp":1784222425000},"page":"bjo-2026-329476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Global retinoblastoma service availability in 2024 and equity trends since 2017"],"prefix":"10.1136","author":[{"name":"The Global Retinoblastoma Study Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"2026090210201110000_bjo-2026-329476v2.1","doi-asserted-by":"crossref","first-page":"e1128","DOI":"10.1016\/S2214-109X(22)00250-9","article-title":"The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries","volume":"10","author":"Fabian","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2026090210201110000_bjo-2026-329476v2.2","doi-asserted-by":"crossref","first-page":"e185","DOI":"10.1016\/S1470-2045(20)30022-X","article-title":"Sustainable care for children with cancer: a Lancet Oncology Commission","volume":"21","author":"Atun","year":"2020","journal-title":"Lancet Oncol"},{"key":"2026090210201110000_bjo-2026-329476v2.3","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1001\/jamaoncol.2019.6716","article-title":"Global Retinoblastoma Presentation and Analysis by National Income Level","volume":"6","author":"Fabian","year":"2020","journal-title":"JAMA Oncol"},{"key":"2026090210201110000_bjo-2026-329476v2.4","unstructured":"World Health Organization . CureAll framework: WHO global initiative for childhood cancer: increasing access, advancing quality, saving lives. 2021. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/347370 [accessed 16 Aug 2023]"},{"key":"2026090210201110000_bjo-2026-329476v2.5","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/08880018.2022.2140860","article-title":"Evaluating the baseline survival outcomes of the \u201csix Global Initiative for Childhood Cancer index cancers\u201d in Africa","volume":"40","author":"van Heerden","year":"2023","journal-title":"Pediatr Hematol Oncol"},{"key":"2026090210201110000_bjo-2026-329476v2.6","unstructured":"World Bank . World bank country and lending groups. Available: https:\/\/data.worldbank.org [accessed 25 Oct 2025]"},{"key":"2026090210201110000_bjo-2026-329476v2.7","unstructured":"World economic outlook database: gross domestic product per capita, current prices (U.S. dollars). International Monetary Fund (IMF); 2024. Available: https:\/\/www.imf.org\/external\/datamapper\/NGDPDPC@WEO\/OEMDC\/ADVEC\/WEOWORLD [Accessed 23 Apr 2025]."},{"key":"2026090210201110000_bjo-2026-329476v2.8","doi-asserted-by":"crossref","unstructured":"O\u2019Donnel O , Doorslaer E , Wagstaff A , et al . Analyzing health equity using household survey data: a guide to techniques and their implementation. World Bank, 2008. 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Global Retinoblastoma Service Availability Datasets, 2017 and 2024. Zenodo 2025. 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