Global health expenditures on cancer control: a cross-sectional analysis

Global health expenditures on cancer control have not previously been systematically quantified. We aimed to identify and harmonise publicly accessible, nationally representative estimates of recurrent expenditures on cancer control globally, benchmark them against national incidence of cancer, and produce estimates of expenditure on cancer control for countries and territories without expenditure data.

In this cross-sectional study, we identified 218 countries and territories for inclusion in our search using the World Bank Open Data classification of economies. We used data on nationally reported expenditure on cancer control from National Health Accounts (NHAs) or NHA subaccounts; government-led reports, studies, or data (eg, NHA synthesis reports, statistical tables, and statistical briefs); government-commissioned reports or studies; or original research in peer-reviewed journals. All countries and territories with available and complete expenditure data on cancer control and corresponding data required for currency or inflation conversion were considered to have met eligibility criteria for the primary analysis and were included. The primary objective was to quantify and compare nationally reported recurrent expenditure on cancer control across countries and territories by use of publicly accessible sources. Primary data sources were compiled via country-by-country searches of the WHO Repository of Health Budgets and the Global Health Expenditure Database, followed by national government, ministry of health, ministry of finance, and audit department websites. If data were still not identified after these initial searches, we searched Google with prespecified terms.

Data were acquired between June 6, 2024, and Dec 20, 2025. Expenditure data on cancer control were available for 81 (37%) of 218 countries and territories, predominantly sourced from NHAs or NHA subaccounts, with data from 77 countries and territories converted to 2022 US dollars for comparative analysis. Median year of expenditure data origin was 2018 (IQR 2017-19). The mean annual expenditure on cancer control per capita for countries and territories with data was $88·9 (SD 145·3). By World Bank income classification, this was $173·4 (169·7) in high-income countries and territories, $15·7 (14·6) in upper-middle-income countries and territories, $3·9 (6·8) in lower-middle-income countries and territories, and $0·4 (0·4) in low-income countries and territories.

Our findings indicate high variability of per-capita health expenditure on cancer control globally and generally low expenditure levels, particularly in lower-middle-income and low-income countries and territories. The paucity of publicly available expenditure data on cancer control indicates the need for production of detailed NHAs that include disease-specific expenditures to ensure availability of regular, comparable, and reliable data.

Harvard University.