# Global cancer surgery: delivering safe, affordable, and timely cancer surgery

Source: https://onco.cc/key-papers/paper-sullivan-lancet-oncol/  
OnCo record `paper-sullivan-lancet-oncol` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Paper cited by two bottleneck pages and 13 idea pages, indexed on Europe PMC as PubMed record 26427363 and published in The Lancet Oncology; the citing pages link this DOI, which is how the record was matched.

## Summary

Surgery 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. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

Indexed on Europe PMC as PubMed record 26427363 (DOI 10.1016/s1470-2045(15)00223-5). Matched by DOI alone: two bottleneck pages and 13 idea pages cite this DOI among their external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: The Lancet Oncology
- Year: 2015
- DOI: 10.1016/s1470-2045(15)00223-5
- Authors: Sullivan R, Alatise OI, Anderson BO, et al.
- What it means: Two bottleneck pages and 13 idea pages on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
- Caveats: Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper.

## Sources

- Lancet Oncol 2015: https://doi.org/10.1016/s1470-2045(15)00223-5
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26427363/
- Europe PMC: https://europepmc.org/article/MED/26427363

## Connected records

- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)
- ideas: [A funded programme of organ-preservation trials to avoid radical surgery](https://onco.cc/ideas/idea-fund-organ-preservation-programme/), [A neutral platform trial for radiotherapy plus immunotherapy combinations](https://onco.cc/ideas/idea-fund-rt-io-platform/), [A pragmatic trial network for intraoperative margin tools, paid on margin reduction](https://onco.cc/ideas/idea-fund-intraoperative-imaging-trials/), [A video-based surgical quality registry linking assessed skill to cancer outcomes](https://onco.cc/ideas/idea-fund-surgical-video-registry/), [An independent evaluation unit for surgical robots and AI, paid on evidence](https://onco.cc/ideas/idea-fund-surgical-ai-robotics-evaluation/), [Compact FLASH and proton systems at the price of a conventional linac](https://onco.cc/ideas/idea-moon-compact-flash-proton/), [Coverage-with-evidence registries for MR-guided and adaptive radiotherapy](https://onco.cc/ideas/idea-fund-adaptive-radiotherapy-evidence/), [Device-agnostic public trials of ablation technologies against surgery](https://onco.cc/ideas/idea-fund-ablation-versus-surgery-trials/), [Pay per course of radiotherapy, not per session, so short courses are not penalised](https://onco.cc/ideas/idea-fund-course-based-radiotherapy-payment/), [Payer-funded trials that omit surgery or radiotherapy in low-risk patients](https://onco.cc/ideas/idea-fund-omission-deescalation-trials/), [Prizes for unpatentable surgical and radiotherapy techniques proven in trials](https://onco.cc/ideas/idea-fund-technique-innovation-prize/), [Real-time margin assessment and image-guided surgery as the global standard](https://onco.cc/ideas/idea-moon-image-guided-surgery-everywhere/), [Validate and reimburse AI contouring and planning to expand radiotherapy capacity](https://onco.cc/ideas/idea-fund-rt-planning-ai-capacity/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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