Global Inequities in Accessing Cancer Surgical Care and Strategies to Address Them

The global cancer burden is expected to rise over the next few decades, with an equally significant increase in the need for cancer surgical services. It is well known that gross inequities exist in accessing cancer surgical care on the global stage. The goal of this manuscript is to highlight the inequities in accessing cancer surgical care and outline some strategies to address them. We used GLOBOCAN 2022 to document the current and predicted rise in the future cancer burden for the various income groups, as defined by the World Bank Group. Data from relevant agencies such as the International Atomic Energy Agency (IAEA), World Bank Group, and relevant publications were used to quantify current and future workforce (surgical and relevant other health professions) needs, number of imaging modalities, hospital capacity, and healthcare expenditure per capita. Our study demonstrates that there are extreme variations in cancer burden on the global stage as well as inequities in all domains of cancer surgical care pathways, based on income status. Low-income (LICs) and lower-middle-income countries (LMICs) will experience a proportionally larger increase in cancer burden over the next few decades. At the same time, LICs and LMICs were noted to have severe shortages in all elements of the cancer surgical care pathways ranging from the number of cancer surgeons and other oncology professionals, hospital beds, and imaging modalities, when compared to high-income countries (HICs). Health care expenditure per capita also demonstrated variations with the highest rates noted in the HICs. This study highlights the inequities in access to cancer surgical care on the global stage. To address these challenges, we have proposed some strategies derived from the 2023 Lancet Oncology Commission on Global Cancer Surgery report, which can realistically be accomplished in a timeframe of 5-15 years.