Passing the Baton: Succession Planning and Mentorship for Cancer Control in Low- and Middle-Income Countries

In low- and middle-income countries (LMICs), leadership in cancer prevention and control is often concentrated among a small number of key individuals across the cancer continuum. While these leaders are crucial to system development, insufficient succession planning and mentorship mean that over-reliance on individuals places cancer prevention and control at risk of disruption during leadership transitions. Grounded in a critical synthesis of the field, this Perspective examines succession planning and mentorship in cancer prevention and control, highlighting how fragile leadership pipelines, the "missing middle" of mid-career professionals, and informal mentorship cultures and structural inequities, weaken system continuity and resilience. The article further examines barriers to effective mentorship in LMICs and proposes strategies centered on institutionalized mentorship, inclusive approaches, and distributed leadership to strengthen continuity and sustainable development of cancer prevention and control systems. A stable leadership structure requires collaboration across career stages, with senior leaders contributing institutional memory and strategic judgement, mid-career professionals anchoring operational delivery and governance, and early-career professionals contributing innovation and fresh perspectives. Importantly, we advocate for succession planning and mentorship to be institutionalized as core functions of cancer systems, rather than left to individual goodwill, to enable this collaborative structure to sustain leadership continuity and resilience.