Key Insights• The South African radiotherapy market operates within a two-tier healthcare system with significant disparities between public and private sectors. In Gauteng province, there are only two public radiotherapy facilities compared to 20 private facilities serving a population of 15.83 million, creating a population-to-facility ratio of 7.9 million people per centre in the public sector .• External Beam Radiotherapy (EBRT) constitutes the largest therapy segment, supported by linear accelerators across public and private facilities. However, significant capacity constraints exist: of the 9 linear accelerators in Gauteng province, only 6 are fully functional due to staffing shortages and operational challenges .• Radiotherapy systems and equipment represent the largest offering segment, with the market facing substantial procurement and maintenance challenges. Bureaucratic tendering processes for equipment acquisition create significant delays, while inadequate maintenance and equipment breakdowns exacerbate resource strain in public facilities .• Hospitals and integrated cancer centres are the largest end-user segment, with public facilities operating an average of 4 linear accelerators and 1 brachytherapy unit staffed with 22 radiotherapists, compared to private facilities averaging 1.27 linear accelerators and 0.27 brachytherapy units with 2.27 radiotherapists .• Regulatory oversight is provided through the South African Health Products Regulatory Authority for medical devices, with quality assurance standards established by the South African Medical Physics Society and South African Association of Physicists in Medicine and Biology through the SASQART practice guidelines, which set minimum testing requirements adapted to reflect the South African working environment .Market Outlook• According to the research report, "South Africa Radiotherapy Market Overview, 2031," published by Actual Market Research, the South Africa Radiotherapy market is expected to reach a market size of more than USD 39 Million by 2031. This growth reflects the need to address significant infrastructure deficits and improve access to radiotherapy services across the country.• The market is expected to benefit from government investment in radiotherapy infrastructure. The National Department of Health has planned equipment procurement across provinces, including a CT simulator for the Northern Cape's Robert Mangaliso Sobukwe Hospital scheduled for procurement in April 2026, and additional linear accelerators and brachytherapy units for the Free State's Universitas Academic Hospital .• Technology adoption is being supported by professional standardisation efforts. The SASQART practice guidelines, published in 2025, establish recommended quality assurance standards for radiation oncology, including minimum test sets, tolerances, and frequencies adapted to reflect the South African working environment while maintaining clinical quality .• The market is also influenced by workforce constraints and public-private disparities.

Staff shortages, remuneration disparities, and equipment breakdowns create systemic challenges that exacerbate waiting times in public facilities . Public facilities have higher workloads and potential resource strain compared to private facilities, with approximately 4,308 patients receiving radiotherapy treatment annually in Gauteng province .• Long-term growth is supported by the rising cancer burden. Cancer incidence in South Africa continues to increase, with bladder cancer and other malignancies driving demand for radiation oncology services . Government initiatives to improve healthcare infrastructure are expected to create sustained demand for radiotherapy equipment and services .Market DynamicsDriver: Rising Cancer Burden and Increasing AwarenessThe primary driver of the South African radiotherapy market is the increasing incidence of cancer across the population. Bladder cancer remains widespread in South Africa, with elderly males being at particular risk, and smoking identified as a significant risk factor . The growing awareness and adoption of radiation therapy in cancer treatment is driving demand for radiotherapy services .

Additionally, technological advancements in radiation oncology treatments are creating opportunities for modernisation, with image-guided radiation therapy and other advanced modalities being adopted across healthcare facilities . Government initiatives to improve healthcare infrastructure further support market growth .Challenge: Public-Private Disparities and Infrastructure ConstraintsA significant challenge facing the South African radiotherapy market is the stark imbalance in the distribution of radiotherapy facilities between the public and private sectors. In Gauteng province, there are only two public radiotherapy facilities compared to 20 private facilities serving a population of 15.83 million . Public facilities operate with significantly higher workloads and resource strain, with 4,308 patients receiving radiotherapy treatment annually using 9 linear accelerators (of which only 6 are currently in use) . Staff shortages, remuneration disparities, and operational challenges such as equipment breakdowns and inadequate maintenance exacerbate these constraints . Bureaucratic tendering processes for equipment acquisition create additional delays, contributing to longer waiting times for patients in the public sector .Trend: Professional Standardisation and Quality AssuranceA major trend shaping the South African radiotherapy market is the professionalisation of radiation oncology through national quality assurance standards.

The SASQART practice guidelines, published in May 2025 by the South African Medical Physics Society and the South African Association of Physicists in Medicine and Biology, establish recommended quality assurance standards for radiation oncology . These guidelines set minimum test requirements, tolerances, and frequencies to be performed by medical physicists and radiation therapy staff, adapted to reflect the South African working environment and resource availability while maintaining the highest clinical and scientific quality of care . This trend toward professional standardisation supports safe implementation of advanced radiotherapy technologies and improves treatment quality across the country.Policies• The South African Health Products Regulatory Authority regulates medical devices, including radiotherapy equipment, requiring compliance with national standards for safety and quality.• The South African Medical Physics Society and the South African Association of Physicists in Medicine and Biology have published the SASQART practice guidelines (2025), establishing quality assurance standards for radiation oncology in South Africa .• The National Department of Health coordinates public sector procurement of radiotherapy equipment, with recent planned procurements including a CT simulator for the Northern Cape and additional linear accelerators and brachytherapy units for the Free State .• The Council for Medical Schemes monitors healthcare market dynamics, including rising healthcare costs and membership trends, which impact the affordability of radiotherapy services .• The Competition Commission has prohibited collective bargaining for tariff determination since 2003, with a draft Interim Block Exemption for Tariffs Determination in the Healthcare Sector under consideration to allow collective determination of tariffs and quality metrics .• Government initiatives to improve healthcare infrastructure support investment in radiotherapy equipment and services, though bureaucratic tendering processes remain a barrier .Segment AnalysisSouth Africa Radiotherapy Market By Therapy Type• External Beam Radiotherapy (EBRT): This is the largest therapy segment, supported by linear accelerators across public and private facilities. In Gauteng province, there are 9 linear accelerators, though only 6 are currently fully operational due to staffing shortages . Public facilities operate an average of 4 linear accelerators, while private facilities average 1.27 linear accelerators . The installed base includes equipment across provinces: KwaZulu-Natal's IALCH complex operates 3 linear accelerators, Greys Hospital operates 2, Limpopo's Pietersburg Tertiary Hospital operates 2, and the Free State's Universitas Academic Hospital operates 2, with a third planned .

Advanced techniques including IMRT and IGRT are increasingly adopted, though access varies significantly between public and private sectors.• Internal / Brachytherapy: This segment is clinically established, particularly for gynaecological cancers. Public facilities operate an average of 1 brachytherapy unit, while private facilities average 0.27 units . Recent planned procurements include additional brachytherapy units for the Free State's Universitas Academic Hospital, scheduled for procurement in April 2026 . Brachytherapy capacity is also available at IALCH (1 unit), Greys Hospital (1 unit), Pietersburg Tertiary Hospital (1 unit), and Klerksdorp-Tshepong Hospital (1 unit) .• Systemic Radiotherapy: This is the fastest-growing therapy segment, driven by the emergence of novel radiopharmaceuticals and targeted radionuclide therapies. The NRF/iThemba LABS has procured a Radio-Thin Layer Chromatograph Scanner for the Nuclear Medicine Department in Cape Town, valued at R 1,542,142.86 with a 5-year service contract, reflecting investment in nuclear medicine capabilities .South Africa Radiotherapy Market By Offering• Radiotherapy Systems/Equipment: This segment holds the largest market share by revenue, driven by high capital costs and infrastructure needs. The installed base includes linear accelerators across provinces: KwaZulu-Natal (IALCH complex with 3 LINACs, Greys Hospital with 2), Limpopo (Pietersburg Tertiary Hospital with 2), North West (Klerksdorp-Tshepong Hospital with 2), Free State (Universitas Academic Hospital with 2, with 1 to be procured in April 2026), and Western Cape (Tygerberg Hospital with 3 LINACs) .

Recent procurement includes a CT simulator for the Northern Cape's Robert Mangaliso Sobukwe Hospital planned for April 2026 .• Software & Services: This is the fastest-growing segment, reflecting increasing digitalisation and the need for maintenance and support. Service contracts are critical, with the NRF/iThemba LABS procurement including a 5-year service contract . Inadequate maintenance and equipment breakdowns are significant challenges in public facilities, creating demand for comprehensive service agreements .South Africa Radiotherapy Market By Application• Cervical Cancer: This is a significant application segment, with brachytherapy playing a critical role. Gynaecological cancers are among the leading indications for radiotherapy in South Africa, with cervical cancer remaining a major public health concern.• Breast Cancer: A major application segment, with breast cancer ranking among the most frequent malignancies in South Africa. Radiotherapy plays a central role in breast-conserving therapy and post-mastectomy treatment.• Bladder Cancer: A significant application area, with bladder cancer widespread in South Africa. A retrospective audit at a Johannesburg academic hospital found 115 patients treated for bladder cancer, with a mean age of 60.7 years, and males constituting 60.9% of cases .• Prostate Cancer: A growing application area, with increased adoption of EBRT and advanced techniques.• Head & Neck Cancer: This is a critical application requiring highly conformal radiation delivery, driving adoption of IMRT and image-guided techniques.• Lung Cancer: A growing application segment, with advanced radiotherapy techniques being adopted.• Other Applications: Includes gastrointestinal cancers, haematological malignancies, and palliative care indications.South Africa Radiotherapy Market By End User• Hospitals & Integrated Cancer Centres: This is the largest end-user segment, operating within the public healthcare system.

Major public facilities include Charlotte Maxeke Johannesburg Academic Hospital, Groote Schuur Academic Hospital, Tygerberg Hospital (3 LINACs), and Universitas Academic Hospital (2 LINACs, with 1 planned) . Public facilities operate an average of 4 linear accelerators and 1 brachytherapy unit, with 22 radiotherapists . These facilities treat significantly higher patient volumes, with approximately 4,308 patients receiving radiotherapy annually in Gauteng province .• Standalone Radiotherapy Centres: This segment includes private facilities, which are more numerous than public facilities. In Gauteng, there are 20 private radiotherapy facilities compared to 2 public facilities . Private facilities average 1.27 linear accelerators and 0.27 brachytherapy units, with 2.27 radiotherapists . The Netcare Medical Physics Centre of Excellence represents private sector infrastructure .• Academic/Research Institutions: This is the fastest-growing segment, reflecting their central role in advancing the field.

Institutions including the University of the Witwatersrand, University of Cape Town, University of the Free State, and Stellenbosch University contribute to clinical research and quality assurance standards . The NRF/iThemba LABS in Cape Town supports nuclear medicine research .• Other Healthcare Facilities: Includes provincial hospitals such as Greys Hospital, IALCH, and Pietersburg Tertiary Hospital, which provide radiotherapy services across provinces . The Northern Cape currently outsources radiotherapy services .South Africa Radiotherapy Market Economics• Equipment procurement in South Africa is conducted through government tenders and direct private investment. Recent procurement includes a CT simulator for the Northern Cape planned for April 2026, and additional LINACs and brachytherapy units for the Free State's Universitas Academic Hospital . The NRF/iThemba LABS procured a Radio-Thin Layer Chromatograph Scanner valued at R 1,542,142.86 with a 5-year service contract .• Service contract pricing reflects the critical clinical role of equipment uptime. The NRF/iThemba LABS procurement includes a 5-year service agreement, demonstrating the importance of comprehensive maintenance contracts .• The Council for Medical Schemes monitors healthcare costs, with total Prescribed Minimum Benefits expenditure rising by 9.09% between 2023 and 2024, from R124.36 billion to R135.66 billion .• Workforce economics present challenges.

Staff shortages, remuneration disparities, and the inability to operate all available linear accelerators due to insufficient personnel constrain service delivery .• Equipment downtime directly affects patient access and treatment outcomes. Of the 9 linear accelerators in Gauteng province, only 6 are currently fully functional due to operational challenges, creating treatment backlogs .• Infrastructure costs are significant. The stark disparity between public and private facilities 2 public versus 20 private facilities in Gauteng reflects investment gaps and access inequities .Market Outlook by Infrastructure, Investment and Industry Development• The National Department of Health has planned equipment procurement across provinces. The Northern Cape's Robert Mangaliso Sobukwe Hospital will procure a CT simulator in April 2026, with radiation therapy currently outsourced . The Free State's Universitas Academic Hospital will procure 1 additional linear accelerator and 1 additional brachytherapy unit in April 2026 .• Quality assurance standards are advancing through the SASQART practice guidelines, published in May 2025. These guidelines establish minimum test requirements, tolerances, and frequencies for medical physicists and radiation therapy staff, adapted to reflect the South African working environment .• Public-private disparities remain significant.

In Gauteng province, there are 20 private radiotherapy facilities compared to 2 public facilities, creating a population-to-facility ratio of 7.9 million people per centre in the public sector .• Workforce development is a critical priority. Public facilities operate an average of 4 linear accelerators with 22 radiotherapists, while private facilities average 1.27 linear accelerators with 2.27 radiotherapists . Staff shortages and remuneration disparities create operational challenges, with public facilities unable to operate all available equipment .• The NRF/iThemba LABS in Cape Town has procured nuclear medicine equipment with a 5-year service contract, reflecting investment in nuclear medicine capabilities .• Cancer burden continues to rise, with bladder cancer and other malignancies driving sustained demand for radiotherapy services. The Journal of the Egyptian National Cancer Institute published findings on bladder cancer prevalence in Johannesburg, highlighting the need for improved prevention, detection, and comprehensive care .• The long-term outlook remains positive as government investment in healthcare infrastructure, professional standardisation efforts, and the rising cancer burden drive sustained demand for radiotherapy equipment and services. However, addressing public-private disparities, workforce constraints, and procurement challenges will be essential to ensuring equitable access to radiotherapy services across all provinces.Considered in this report• Historic Year: 2020• Base year: 2025• Estimated year: 2026• Forecast year: 2031Aspects covered in this report• Radiotherapy Market with its value and forecast along with its segments• Various drivers and challenges• On-going trends and developments• Top profiled companies• Strategic recommendationBy Therapy Type• External Beam Radiotherapy (EBRT)• Internal / Brachytherapy• Systemic RadiotherapyBy Offering• Radiotherapy Systems/Equipment• Software & ServicesBy Application• Breast Cancer• Prostate Cancer• Lung Cancer• Head & Neck Cancer• Central Nervous System / Brain• Gastro-intestinal• Other ApplicationsBy End User• Hospitals & Integrated Cancer Centers• Standalone Radiotherapy Centers• Academic/Research Institutions• Other Healthcare Facilities.