The Lancet Oncology: 15 years and counting…

Abstract

For much of 2015, The Lancet Oncology—in partnership with The Lancet—has been engaged in a major cancer campaign that saw publication of four Commissions. These major reports have addressed the challenges to cancer control globally, including the great strides made, but also the many hurdles left to overcome. The depressing reality is that a majority of the cancer burden exists, or will soon exist, in those countries least equipped to deal with the problem. In far too many countries, access to the most basic services (eg, safe general surgery, pain relief, the drugs included in the latest edition of the WHO essential medicines list, and adequate therapy) is simply not available. And the true price of cancer control is now beyond the reach of most countries worldwide: major structural and societal change is needed. Expanding global access to radiotherapyRadiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Full-Text PDF Global cancer surgery: delivering safe, affordable, and timely cancer surgerySurgery is essential for global cancer care in all resource settings. Of the 15·2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. Full-Text PDF The expanding role of primary care in cancer controlThe nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. Full-Text PDF Progress and remaining challenges for cancer control in Latin America and the CaribbeanCancer is one of the leading causes of mortality worldwide, and an increasing threat in low-income and middle-income countries. Our findings in the 2013 Commission in The Lancet Oncology showed several discrepancies between the cancer landscape in Latin America and more developed countries. We reported that funding for health care was a small percentage of national gross domestic product and the percentage of health-care funds diverted to cancer care was even lower. Funds, insurance coverage, doctors, health-care workers, resources, and equipment were also very inequitably distributed between and within countries. Full-Text PDF