Priorities and funding for global cancer surgery research.

T. Peter Kingham, MD, Ophira Ginsburg, MD, MSc, Sudha Sivaram, PhD, Andre Ilbawi, MD, and Ted Trimble, MD, MPH3

The UN High Level Meeting on the Prevention and Control of Non-Communicable Diseases (NCDs) held in 2011 drew attention to the global burden of NCDs, including cancer. While there was no specific mention of surgery in general or cancer surgery in particular, this high level discussion brought to attention the burden of cancer and garnered international agreement to launch cancer control efforts. Further highlighting the need for global commitment to research, objective #5 of WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 calls on all stakeholders to promote and support national capacity for high-quality research in order to achieve the target of 25% relative reduction in premature mortality from NCDs by 2025.1 The core principle is that research, while relevant globally, must be applied locally at the regional and national levels. The Sustainable Development Goals, adopted by the UN General Assembly in 2015, include NCDs as part of the overall health goal. Several of the nine health targets included in the SDGs are related to NCD-related health issues. Target 3.4, for example, is to “reduce by one third premature mortality from NCDs through prevention and treatment, and promote mental health and well being.”

An analysis of cancer incidence and prevalence data conducted by Globocan in 2012 attests to the urgency of addressing cancer. However, access to cancer treatment, particularly access to surgery, poses a significant barrier to cancer survivorship. Approximately 5 billion people are estimated to lack access to safe, affordable surgical and anesthesia care.2 This represents a major contributor to the striking global inequities in cancer survival. The Lancet Commision on Global Surgery report supported the World Health Assembly’s unanimous endorsement of a resolution regarding global surgery and anesthesia in 2015.3 This resolution also made clear that surgery should be considered an essential part of global health. Subsequently, the Lancet Oncology Commission on Global Cancer Surgery estimated that over 80% of the 15.2 million new cancer patients diagnosed in 2015 would require a surgical intervention as part of their treatment plan (Table 1).4 All countries are projected to lose up to 1.5% of GDP annually between 2015 and 2030 if cancer surgical systems are not strengthened. Improved surgical oncology services can minimize catastrophic financial events for patients and their families; countries, therefore, should recognize that investment in surgical oncology services can have major positive impacts on both health and household economics of their populations.4

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