Global Disparities in Cancer Genetic Testing Highlighted by New Lancet Report
A recent Lancet Oncology commission reveals stark inequalities in access to genomic testing for cancer treatment worldwide.
Only 2% of biomarker-based cancer trials occur in low- and middle-income countries.
Global spending on cancer medications is projected to reach $441 billion by 2029.
The commission recommends a framework for equitable access to precision oncology.
A new report from The Lancet Oncology underscores the significant global disparities in access to cancer genetic testing and treatments, revealing that low- and middle-income countries (LMICs) are severely underrepresented in this critical area. The commission's findings indicate that a mere 2% of biomarker-based cancer trials are conducted in LMICs, while high-income nations account for nearly 81% of such research.
The report highlights a troubling trend referred to as the "paradox of success," where advancements in precision oncology have led to increased costs and complexity, outpacing the benefits provided to populations. Over the past five years, global expenditure on cancer medications has surged by approximately 75%, reaching an estimated $252 billion in 2024, with projections suggesting it could climb to $441 billion by 2029.
Researchers conducted a comprehensive analysis of clinical trial data and genomic datasets, alongside a survey of national cancer programs. They estimate that between seven to eight million individuals diagnosed with cancer globally require standard molecular testing annually. However, access to these tests remains limited, particularly in LMICs, where coverage is far from universal.
For instance, approximately 314,000 women diagnosed with ovarian cancer are eligible for BRCA testing each year, yet nearly half do not receive it. This gap is largely attributed to inadequate testing infrastructure in LMICs, as highlighted by the commission's findings.
To address these disparities, the commission has proposed a strategic framework aimed at prioritizing molecular tests and therapies, coupled with a readiness assessment tool for health systems. Additionally, it has outlined a workforce competency framework and principles for responsible data sharing. The report concludes with ten core recommendations to ensure the equitable integration of precision oncology into cancer control efforts and universal health coverage, along with a phased implementation roadmap.
