{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:41:29Z","timestamp":1789166489035,"version":"build-2803163510"},"reference-count":90,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am Soc Clin Oncol Educ Book"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Global cancer incidence is projected to rise dramatically, with over 35 million new cases anticipated by 2050, disproportionately affecting low- and middle-income countries (LMICs) where up to 70% of cancer deaths are expected to occur. This manuscript provides an in-depth assessment of the structural, economic, and sociocultural barriers that drive cancer care disparities in LMICs, including limited access to prevention, diagnosis, treatment, and palliative care services. Key challenges include shortages in oncology workforce, diagnostic infrastructure, radiotherapy access, and participation in clinical trials. Socioeconomic inequities, stigma, and high out-of-pocket costs further exacerbate delayed care and poor outcomes. Some innovative interventions have improved access and quality of cancer care in resource constrained settings. These include task-shifting models, digital health tools, community-based awareness and screening programs, and South-South collaborations that foster local drug innovation and manufacturing. It also explores emerging strategies in precision medicine, AI-assisted decision making, and tele-oncology tailored to LMICs. The role of public-private partnerships, sustainable financing, and international collaborations in advancing cancer control is critically examined. The future of global oncology hinges on a shift from fragmented, reactive responses to coordinated, data-driven, and sustainable strategies. By strengthening health systems and embracing context-sensitive innovation, the global community can address the widening cancer care gap and improve outcomes for vulnerable populations worldwide.<\/jats:p>","DOI":"10.1200\/edbk-25-473930","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T15:59:06Z","timestamp":1750175946000},"source":"Crossref","is-referenced-by-count":29,"title":["Global Oncology: Tackling Disparities and Promoting Innovations in Low- and Middle-Income Countries"],"prefix":"10.1200","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-0642","authenticated-orcid":false,"given":"Regina","family":"Barragan-Carrillo","sequence":"first","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick Chite","family":"Asirwa","sequence":"additional","affiliation":[{"name":"International Cancer Institute, Eldoret, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5997-318X","authenticated-orcid":false,"given":"Rodrigo","family":"Dienstmann","sequence":"additional","affiliation":[{"name":"Oncocl\u00ednicas Medicina de Precis\u00e3o, S\u00e3o Paulo, Brazil"},{"name":"Vall d\u2019Hebron Institute of Oncology, Barcelona, Spain"},{"name":"University of Vic\u2014Central University of Catalonia, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Pendhakar","sequence":"additional","affiliation":[{"name":"Sarvodaya Cancer Institute, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0446-123X","authenticated-orcid":true,"given":"Erika","family":"Ruiz-Garcia","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_100045"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01738-x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2022.02.003"},{"key":"e_1_3_4_6_2","volume-title":"Cervical Cancer","unstructured":"Cervical Cancer. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cervical-cancer"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30123-2"},{"key":"e_1_3_4_8_2","article-title":"Avoidable mortality: The core of the global cancer divide","author":"Knaul FM","unstructured":"Knaul FM, Arreola-Ornelas H, Rodriguez NM, et al: Avoidable mortality: The core of the global cancer divide. JCO Glob Oncol 10.1200\/JGO.17.00190","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_431272"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.10.062"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1515\/ohe-2025-0058"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-5169-9"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00223-5"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100292"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-01962-y"},{"key":"e_1_3_4_16_2","article-title":"Global survey of clinical oncology workforce","author":"Mathew A","unstructured":"Mathew A: Global survey of clinical oncology workforce. JCO Glob Oncol 10.1200\/JGO.17.00188","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00053-0"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpi.2024.100369"},{"key":"e_1_3_4_19_2","volume-title":"Cancer Care in Pandemic Times: Building Inclusive Local Health Security in Africa and India","author":"Banda G","unstructured":"Banda G, Mackintosh M, Njeru MK, et al (eds): Cancer Care in Pandemic Times: Building Inclusive Local Health Security in Africa and India. Cham, Switzerland, Springer International Publishing, 2024"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00700-7"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.7574"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2014.10.006"},{"key":"e_1_3_4_23_2","article-title":"Access to radiation therapy: From local to global and equality to equity","author":"Laskar SG","unstructured":"Laskar SG, Sinha S, Krishnatry R, et al: Access to radiation therapy: From local to global and equality to equity. JCO Glob Oncol 10.1200\/GO.21.00358","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00222-3"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21121597"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.12.012"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2023.06.009"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-13352-3"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.27252"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/107327481602300404"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1353\/pbm.2020.0025"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0301059"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol32020071"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-07270-5"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101517"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32513-8"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241248324"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-023-01144-w"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.47.8412"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223537"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106242"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808516"},{"key":"e_1_3_4_43_2","article-title":"Recommendations from the ASCO academic global oncology task force","author":"Gralow JR","unstructured":"Gralow JR, Asirwa FC, Bhatt AS, et al: Recommendations from the ASCO academic global oncology task force. JCO Glob Oncol 10.1200\/GO.20.00497","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.803528"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2013.06.001"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2023.08.010"},{"key":"e_1_3_4_47_2","first-page":"413","article-title":"Cancer registries can provide evidence-based data to improve quality of care and prevent cancer deaths","volume":"8","author":"Bouchardy C","year":"2014","unstructured":"Bouchardy C, Rapiti E, Benhamou S: Cancer registries can provide evidence-based data to improve quality of care and prevent cancer deaths. Ecancermedicalscience 8:413, 2014","journal-title":"Ecancermedicalscience"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2023.07.007"},{"key":"e_1_3_4_49_2","unstructured":"McElwee F Cole A Kaliappan G et al: Alternative payment models for innovative medicines: A framework for effective implementation. Appl Health Econ Health Policy 10.1007\/s40258-025-00960-1 [epub ahead of print on April 2 2025]"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-024-00809-y"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2024.100464"},{"key":"e_1_3_4_52_2","article-title":"Emerging use of public-private partnerships in public radiotherapy facilities in Nigeria","author":"Anakwenze Akinfenwa CP","unstructured":"Anakwenze Akinfenwa CP, Ibraheem A, Nwankwo K, et al: Emerging use of public-private partnerships in public radiotherapy facilities in Nigeria. JCO Glob Oncol 10.1200\/GO.21.00066","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-023-10220-9"},{"key":"e_1_3_4_54_2","article-title":"Innovative use of mHealth and clinical technology for oncology clinical trials in Africa","author":"Mutebi M","unstructured":"Mutebi M, Bhatia R, Salako O, et al: Innovative use of mHealth and clinical technology for oncology clinical trials in Africa. JCO Glob Oncol 10.1200\/JGO.19.00191","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00438"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.34172\/hpp.2023.23"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-021-00163-8"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10020391"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00385-6"},{"key":"e_1_3_4_60_2","volume-title":"CRTI LA Spanish","author":"Hematology.org","unstructured":"Hematology.org: CRTI LA Spanish. https:\/\/www.hematology.org\/awards\/career-enhancement-and-training\/clinical-research-training-institute-latin-america\/crti-la-spanish"},{"key":"e_1_3_4_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00077-2"},{"key":"e_1_3_4_62_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01015"},{"key":"e_1_3_4_63_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01730"},{"key":"e_1_3_4_64_2","article-title":"Cancer care disparities: Overcoming barriers to cancer control in low- and middle-income countries","author":"Bamodu OA","unstructured":"Bamodu OA, Chung CC: Cancer care disparities: Overcoming barriers to cancer control in low- and middle-income countries. JCO Glob Oncol 10.1200\/GO.23.00439","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_65_2","volume-title":"India\u2019s First Homegrown CAR T-Cell Therapy\u2014NCI","year":"2024","unstructured":"India\u2019s First Homegrown CAR T-Cell Therapy\u2014NCI. 2024. https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2024\/nexcar19-car-t-cell-therapy-india-nci-collaboration"},{"key":"e_1_3_4_66_2","doi-asserted-by":"publisher","DOI":"10.3389\/frtra.2023.1238535"},{"key":"e_1_3_4_67_2","article-title":"Precision oncology: A global perspective on implementation and policy development","author":"Horgan D","unstructured":"Horgan D, Tanner M, Aggarwal C, et al: Precision oncology: A global perspective on implementation and policy development. JCO Glob Oncol 10.1200\/GO-24-00416","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_68_2","article-title":"Real-world study on implementation of genomic tests for advanced lung adenocarcinoma in Brazil","author":"Dienstmann R","unstructured":"Dienstmann R, Da Silva LM, Orpinelli Ramos Do Rego F, et al: Real-world study on implementation of genomic tests for advanced lung adenocarcinoma in Brazil. JCO Glob Oncol 10.1200\/GO-24-00354","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_4_69_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3935"},{"key":"e_1_3_4_70_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0255"},{"key":"e_1_3_4_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30269-9"},{"key":"e_1_3_4_72_2","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-23-1199"},{"key":"e_1_3_4_73_2","first-page":"ubae019","article-title":"Large language models in cancer: Potentials, risks, and safeguards","volume":"2","author":"Zitu MM","year":"2025","unstructured":"Zitu MM, Le TD, Duong T, et al: Large language models in cancer: Potentials, risks, and safeguards. BJR Artif Intell 2:ubae019, 2025","journal-title":"BJR Artif Intell"},{"key":"e_1_3_4_74_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-019-0227-8"},{"key":"e_1_3_4_75_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2023.06.008"},{"key":"e_1_3_4_76_2","volume-title":"Volunteer Abroad with ASCO\u2019s International Cancer Corps","author":"ASCO Connection","unstructured":"ASCO Connection: Volunteer Abroad with ASCO\u2019s International Cancer Corps. https:\/\/connection.asco.org\/do\/volunteer-abroad-ascos-international-cancer-corps"},{"key":"e_1_3_4_77_2","volume-title":"Oncology Volunteer Opportunities","author":"Health Volunteers Overseas","unstructured":"Health Volunteers Overseas: Oncology Volunteer Opportunities. https:\/\/hvousa.org\/specialty-areas\/oncology\/"},{"key":"e_1_3_4_78_2","volume-title":"Cervical Cancer Elimination Initiative","unstructured":"Cervical Cancer Elimination Initiative. https:\/\/www.who.int\/initiatives\/cervical-cancer-elimination-initiative"},{"key":"e_1_3_4_79_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2020-0228"},{"key":"e_1_3_4_80_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00747-5"},{"key":"e_1_3_4_81_2","unstructured":"IAEA\/WHO Joint Statement on Reducing Inequity in Access to Cancer Care through Rays of Hope Initiative. https:\/\/www.who.int\/news\/item\/04-02-2022-iaea-who-joint-statement-on-reducing-inequity-in-access-to-cancer-care-through-rays-of-hope-initiative"},{"key":"e_1_3_4_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00533-8"},{"key":"e_1_3_4_83_2","volume-title":"Access to Oncology Medicines (ATOM) Coalition","author":"Global Health Progress","unstructured":"Global Health Progress. Access to Oncology Medicines (ATOM) Coalition. https:\/\/globalhealthprogress.org\/collaboration\/access-to-oncology-medicines-atom-coalition\/"},{"key":"e_1_3_4_84_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S459873"},{"key":"e_1_3_4_85_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.628744"},{"key":"e_1_3_4_86_2","volume-title":"The Global Initiative for Childhood Cancer","unstructured":"The Global Initiative for Childhood Cancer. https:\/\/www.who.int\/initiatives\/the-global-initiative-for-childhood-cancer"},{"key":"e_1_3_4_87_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad255"},{"key":"e_1_3_4_88_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-136"},{"key":"e_1_3_4_89_2","volume-title":"Kabarak University\u2019s Master of Oncology Pharmacy Students Complete Clinical Rotation at International Cancer Institute","author":"University K","year":"2025","unstructured":"University K: Kabarak University\u2019s Master of Oncology Pharmacy Students Complete Clinical Rotation at International Cancer Institute. 2025. https:\/\/kabarak.ac.ke\/sop-news\/kabus-master-of-oncology-pharmacy-students-complete-clinical-rotation-at-ici"},{"key":"e_1_3_4_90_2","volume-title":"New Training Program Addresses Cancer Care Knowledge Gaps in Africa | News","author":"Riley L","year":"2022","unstructured":"Riley L: New Training Program Addresses Cancer Care Knowledge Gaps in Africa | News. Rutgers Global Health Institute, 2022. https:\/\/globalhealth.rutgers.edu\/news\/new-training-program-addresses-cancer-care-knowledge-gaps-in-africa\/"},{"key":"e_1_3_4_91_2","first-page":"1","article-title":"Cancer Groundshot: Building a robust cancer control platform in addition to launching the cancer Moonshot","volume":"42","author":"Mutebi M","year":"2022","unstructured":"Mutebi M, Dehar N, Nogueira LM, et al: Cancer Groundshot: Building a robust cancer control platform in addition to launching the cancer Moonshot. Am Soc Clin Oncol Educ Book 42:1-16, 2022","journal-title":"Am Soc Clin Oncol Educ Book"}],"container-title":["American Society of Clinical Oncology Educational Book"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/EDBK-25-473930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T19:59:13Z","timestamp":1752609553000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/EDBK-25-473930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":90,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1200\/EDBK-25-473930"],"URL":"https:\/\/doi.org\/10.1200\/edbk-25-473930","relation":{},"ISSN":["1548-8748","1548-8756"],"issn-type":[{"value":"1548-8748","type":"print"},{"value":"1548-8756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"article-number":"e473930"}}