Even though more than 80 percent of the 15 million people diagnosed with cancer globally in 2015 require surgery, less than a quarter of them have access to it, according to a new commission published in The Lancet Oncology.

Less than 5 percent of patients in low-income countries and only 22 percent of patients in middle-income counties have access to basic cancer surgery. The international community does not view surgical care as an important part of global cancer control, according to the commission.

"With many competing health priorities and substantial financial constraints in many low- and middle-income countries, surgical services for cancer are given low priority within national cancer plans and are allocated few resources,” Richard Sullivan, lead commissioner and professor at the Institute of Cancer Policy, King's Health Partners Comprehensive Cancer Centre at King's College London, UK, said in a statement.
But the poorer countries are not the only ones facing this issue. According to survival data across Europe, many states in the EU are also not providing high-quality cancer surgery to their patients.

On top of that, the demand for cancer surgery is rising. Out of almost 22 million new cancer patients, over 17 million will require operations by 2030 and 10 million of them are in low- and middle-income countries.

If surgical services don’t receive immediate investment, the global economy will lose $12 trillion by 2030 due to cancer that could have been treated surgically. In addition, not training more cancer surgeons and improving cancer surgical systems could result in a loss of another $6 trillion between now and 2030.

Over 82 percent of countries are experiencing a shortage of cancer surgeons, and “radical action” is needed to train general surgeons on basic cancer surgery, according to the commission. More gynecological and surgical oncologists and more high-quality surgical training programs are also needed.

Policymakers, patients and the public also need to be educated on important issues involving delivering safe, affordable and timely surgical care. Riccardo Audisio, co-author and president of the European Society for Surgical Oncology, said in a statement that policymakers on all levels still have little awareness of the central importance of surgery to cancer control.

“It is imperative that surgery is at the heart of global and national cancer plans,” said Sullivan. “A powerful political commitment is needed in all countries to increase investment and training in publicly funded systems of cancer surgery.”

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