Inequities in global cancer surgery: Challenges and solutions

The disparity in access to and quality of surgical cancer care between high and low resource settings impacts immediate and long-term oncological outcomes. With cancer incidence and mortality set to increase rapidly in the next few decades, we examine the factors leading to inequities in global cancer surgery, and look at potential solutions to overcome these challenges. GLOBOCAN data estimates that in 2030, there will be over 24 million new cases of cancer globally, with almost 13 million deaths.1 Around 17 million patients will need surgery for cancer, some multiple times, accounting for as many as 45 million operations.2 Other estimates project a 52% increase in the need for cancer surgeries between 2018 and 2040 with approximately 5 million more procedures needed for cancer-related indications in 2040 compared to 2018.3 This increase will impact lower resource settings disproportionately, with more than 10 million patients in low and middle-income countries (LMICs) needing cancer surgery in 2030.2 Yet, it is in these countries and resource constrained settings that capacity for cancer surgery is so limited. This mismatch will have real social and economic consequences creating not just profound gross domestic product (GDP) losses but also contributing, if not addressed, to stagnant and even declining cancer outcomes.