Cancer Care Disparities: Overcoming Barriers to Cancer Control in Low- and Middle-Income Countries

Author:

Bamodu Oluwaseun Adebayo123ORCID,Chung Chen-Chih456ORCID

Affiliation:

1. Directorate of Postgraduate Studies, School of Clinical Medicine, Muhimbili University of Health and Allied Sciences, Ilala District, Dar es Salaam, Tanzania

2. Ocean Road Cancer Institute, Ilala District, Dar es Salaam, Tanzania

3. Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington DC

4. Department of Neurology, Taipei Medical University—Shuang Ho Hospital, New Taipei City, Taiwan

5. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan

6. Taipei Neuroscience Institute, Taipei Medical University—Shuang Ho Hospital, New Taipei City, Taiwan

Abstract

The rising global burden of cancer disproportionately affects low- and middle-income countries (LMICs), which account for over half of new patients and cancer deaths worldwide. However, LMIC health systems face profound challenges in implementing comprehensive cancer control programs because of limited health care resources and infrastructure. This analytical review explores contemporary evidence on barriers undermining cancer control efforts in resource-constrained LMIC settings. We conducted a comprehensive literature review of peer-reviewed evidence on cancer control challenges and solutions tailored to resource-limited settings. We provide a conceptual framework categorizing these barriers across the cancer care continuum, from raising public awareness to palliative care. We also appraise evidence-based strategies proposed to overcome identified obstacles to cancer control in the published literature, including task-shifting to nonspecialist health workers, strategic prioritization of high-impact interventions, regional collaborations, patient navigation systems, and novel financing mechanisms. Developing strong primary care delivery platforms integrated with specialized oncology care, alongside flexible and resilient health system models tailored to local contexts, will be critical to curb the rising tide of cancer in resource-limited settings. Urgent global commitments and investments are needed to dismantle barriers and expand access to prevention, early detection, diagnosis, treatment, and palliation services for all patients with cancer residing in LMICs as an ethical imperative. The review elucidates priority areas for policy actions, health systems strengthening, and future research to guide international efforts toward more equitable cancer control globally.

Publisher

American Society of Clinical Oncology (ASCO)

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