Global Oncology Index: Mapping Disparities in Cancer Care Across Globe

Cancer is a leading global health challenge, with 20 million new cases and 10 million deaths reported in 2022 (GLOBOCAN). Disparities in cancer care, driven by socioeconomic status and healthcare infrastructure, result in higher mortality in low- and middle-income countries (LMICs). The Global Oncology Index (GOI) aims to quantify these disparities and guide targeted interventions.

The 2025 GOI was developed for 141 countries using incidence-mortality factors from GLOBOCAN 2022 and radiotherapy (RT) infrastructure from the International Atomic Energy Agency (IAEA) register, as radiation is an indispensable part of cancer therapy for around 50% of patients, and RT machine related details were possible to retrieve reliably from the IAEA register, unlike those of surgical and chemotherapeutical centres The GOI formula, [(Incidence age-standardized rate (ASR) - Mortality ASR)/Mortality ASR] × RT centers per million population, integrates cancer burden with treatment capacity. Correlation with Human Development Index (HDI) was assessed.

GOI scores ranged from 22.29 (United States) to 0.006 (Ethiopia). High-income countries, including Australia (17.69) and Japan (14.81), led the rankings, while LMICs in Africa and Asia (eg Yemen: 0.007) ranked lowest. Countries are categorized into very low, low, medium, and high GOI country depending on percentile values. Very low GOI countries have a GOI of less than 0.17 (25th percentile), low GOI countries have a GOI between 0.17 and 0.889 (25th-50th percentile), medium GOI countries have a GOI between 0.89 and 2.329 (50th-75th percentile) and high GOI countries have a GOI value between 2.33 or more (>75th percentile). A significant positive correlation (r = 0.574, P < .001) was also observed between GOI and HDI, highlighting socioeconomic influences on oncology outcomes.

The GOI underscores global oncology disparities, emphasizing the need for enhanced RT infrastructure and early detection in LMICs. While RT-focused, the index may overlook other treatment modalities, suggesting future refinements to improve comprehensiveness.