Perceptions of Planetary Health and Sustainability Among Canadian Radiation Oncology Professionals: A National Survey

Background: Climate change poses increasing risks to human health and healthcare delivery, including increased cancer burden, treatment disruptions, and exacerbation of comorbidities.Despite growing international attention to sustainable cancer care, Canadian data on professional perceptions, institutional practices, and priorities for action within radiation oncology remain limited.Objective: This study aimed to assess perceptions, knowledge, and workplace practices related to planetary health and sustainability among Canadian radiation oncology professionals.Methods: A cross-sectional electronic survey was distributed to Canadian radiation oncology professionals and trainees through the Canadian Association of Radiation Oncology (CARO) membership email list and departmental distribution across cancer centers.The 27-item questionnaire was developed based on previously validated climate perception and sustainability surveys, including SASSY and CHANT, and assessed perceptions of climate change and health impacts, workplace sustainability practices, and priorities for action.Responses were anonymous and analyzed using descriptive statistics.Results: A total of 108 respondents completed the survey, including radiation oncologists, therapists, physicists, nurses, and trainees from nine provinces.Climate change was rated as a personal priority by 73% (n = 79/108) of respondents, and 75% (n = 81/108) agreed that it would increase cancer incidence.Support for prioritizing low-carbon, low-waste cancer care was high (77%; n = 83/108).However, only 34% (n = 37/108) reported the presence of a sustainability initiative at their cancer center, and 62% (n = 67/108) felt sustainability was not a workplace priority.Strong support was expressed for CARO-led initiatives, including member education on planetary health (77%; n = 83/108), sustainability recommendations for clinical practice (76%; n = 82/108), and evaluation of radiation oncology's carbon footprint (69%; n = 75/108).Interest in reducing CARO ASM emissions was high, with 58% (n = 63/108) supporting at least a 30% reduction.Conclusion: While Canadian radiation oncology professionals recognize the relevance of climate change to cancer care and support action in sustainability, institutional implementation remains limited.Future work should evaluate strategies to engage broader professional groups and increase awareness and participation in sustainability initiatives in radiation oncology.