Availability of technology for managing cancer patients in the Southeast European (SEE) region.

Background: The Southeast European (SEE) region of 10 countries and about 43 million people differs from Western Europe in that most SEE countries lack active cancer registries and have fewer diagnostic imaging devices and radiotherapy (RT) units. The main objective of this research is to initiate a common platform for gathering SEE regional cancer data from the ground up to help these countries develop common cancer management strategies. Methods: To obtain detailed on-the-ground information, we developed separate questionnaires for two SEE groups: a) ONCO - oncologists regarding cancer treatment modalities and the availability of diagnostic imaging and radiotherapy equipment; and b) REG - national radiation protection and safety regulatory bodies regarding diagnostic imaging and radiotherapy equipment in SEE facilities. Results: Based on responses from 13/17 ONCO participants (at least one from each country) and from 9/10 REG participants (all countries but Albania), cancer incidence rates are higher in those SEE countries that have greater access to diagnostic imaging equipment while cancer mortality-to-incidence (MIR) ratios are higher in countries that lack radiotherapy equipment. Conclusion: By combining unique SEE region information with data available from major global databases, we demonstrated that the availability of diagnostic imaging and radiotherapy equipment in the SEE countries is related to their economic development. While immediate diagnostic imaging and radiation therapy capacity building is necessary, it is also essential to develop both national and SEE-regional cancer registries in order to understand the heterogeneity of each country's needs and to establish regional collaborative strategies for combating cancer.

MAIN FINDINGS FROM RADON INDOOR SURVEY IN MONTENEGRO.

Recent residential radon survey in Montenegro revealed the national average annual radon activity concentrations: unweighted AM = 110 Bq m-3, GM = 58.3 Bq m-3, and population weighted (AM)w = 100.5 Bq m-3, (GM)w = 92.8 Bq m-3. Based on (AM)w and dose conversion factor of 9 nSv per Bq h m-3, average effective dose from exposure to indoor radon at homes is estimated to be 1.58 mSv y-1. 222Rn was measured with CR-39 detectors for two consecutive six-month periods. Radon concentrations are discussed with respect to their distribution, to the seasons, climate zones, urban and rural areas, house types, floor levels, basement and foundation slab. Average radon concentrations are calculated for each municipality and for cells of a 10 km × 10 km grid, and corresponding radon maps of Montenegro are then produced.

Radon survey in Montenegro - A base to set national radon reference and "urgent action" level.

The first nationwide indoor radon survey in Montenegro started in 2002 and year-long radon measurements with CR-39 track-etch detectors, within the national grid of 5 km × 5 km and local grids in urban areas of 0.5 km × 0.5 km, were performed in homes in half of the country's territory. The survey continued in 2014 and measurements in the rest of the country were completed at the end of 2015. The 953 valid results, obtained in the national radon survey, give an average radon activity concentration in Montenegrin homes of 110 Bq/m3. Assuming a log-normal distribution of the experimental results, geometric mean GM = 58.3 Bq/m3 and geometric standard deviation GSD = 2.91 are calculated. However, normality tests show that the experimental data are not log-normal, and that they become closest to a log-normal distribution after subtracting from them radon concentration in the outdoor air of 7 Bq/m3, which is theoretically calculated. Such a transformed distribution has GMtr = 46.7 Bq/m3 and GSDtr = 3.54. The estimations derived from positing a priory that the experimental results conform to a log-normal distribution underestimate the percentage of homes with radon concentrations at the thresholds of 300 Bq/m3 and above, which is better estimated by using GMtr and GSDtr. Based on the results of radon survey, a new national radon reference level of 300 Bq/m3 and an "urgent action level" of 1000 Bq/m3 are suggested, with estimated fractions of the national dwelling stock above these levels of 7.4% and 0.8% respectively. Fractions of homes with radon concentrations above the suggested levels are also estimated for each of the 23 municipalities in Montenegro, using appropriate GMtr and GSDtr. The six municipalities which have more than 10% of homes with radon concentration above 300 Bq/m3 are recommended as radon priority areas.