Societal Impact StatementAs the second‐leading cause of mortality worldwide, cancer is a major focus of drug discovery research. Traditional plant knowledge can guide the search for undiscovered compounds, but the efficacy of this approach for cancer, a highly complex disease affecting diverse tissues, is unknown. We investigated the patterns underlying plant selection for cancer treatment globally, finding certain lineages are repeatedly targeted. While this indicates therapeutic value, their relatedness with plants used for unrelated ethnobotanical uses suggests that plants are probably selected to treat cancer‐associated symptoms, rather than addressing tumour growth. Careful re‐examination and scoring of ethnobotanical reports may make the prediction of lineages for drug discovery more informative.Summary Cancer is a highly diverse disease and as the second‐leading cause of death worldwide is a focus of drug discovery research. Natural products have been shown to be a useful source of novel molecules for treating cancer. It is likely there are many plants with undiscovered molecules of therapeutic value, however identifying new leads from the vast diversity of plants is very challenging. Traditional knowledge might inform bioprospecting by predicting lineages of plants rich in therapeutically useful molecules. We characterise the phylogenetic diversity of plants used in traditional cancer management using a comprehensive genus‐level phylogeny of angiosperms, and a list of 597 genera used globally to treat different cancers. We phylogenetically predict which lineages may have elevated potential for drug discovery and assess the quality of the prediction. We demonstrate the independent and repeated targeting of specific lineages of plants by different peoples in different parts of the world. However, the lineages we report here as rich in plants used in traditional cancer management coincide with those for other ethnobotanical applications and contain few plants with proven anti‐cancer activity. That the same lineages are used to treat different cancers is suggestive of independent discovery of therapeutic value. However, it is likely that the traditional knowledge explored here is shaped by the selection of plants conferring milder effects for treating wider symptoms, such as tiredness or nausea, rather than for halting tumour growth. Accurate prediction of useful plant lineages for cancer management requires more nuanced information than is commonly provided in ethnobotanical records.
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