Elevating cancer as a policy priority—with sufficient investment and political will—can unlock health, economic, and social benefits. The benefits of cancer interventions and research often outweigh their costs, making a clear economic case for sustained financing by governments, health providers, international financial institutions, non-governmental organizations (NGOs), and the private sector. In the absence of greater cooperation, action, and investment, cancer’s burden will continue to intensify, placing costs on patients and families, sapping economic growth, inundating health systems, and slowing progress on global development goals. Closing cancer care gaps can support healthier, more prosperous communities, and need to be consistently prioritized on international policy agendas, such as at the World Economic Forum, World Health Assembly, G7 and G20 annual summits, and UN General Assembly.

To maximize the potential of cancer care globally, the following priorities deserve greater policy attention and expanded fiscal resources, domestically and internationally:

• Elevate patient priorities and socioeconomic context in program design and evaluation to ensure access, particularly for marginalized populations.
• Implement proven, high-impact interventions to benefit large numbers of patients, such as smoking and alcohol reduction and increased screening and vaccination.
• Engage in targeted and inclusive policy planning, with the development of cancer control plans for all countries, reflecting country infrastructure and needs.
• Fund cancer control policies and monitor implementation, particularly tracking progress in highest-risk populations, harnessing global funding resources. 
• Increase access to cancer diagnostics and treatment.

Absent a seismic shift in multistakeholder engagement and investment, cancer’s health burden will grow substantially by 2050, endangering lives and livelihoods.

Health systems across the globe are facing growing pressure from NCDs, which are responsible for 74 percent of all deaths globally, due to rising health care costs, mortality and disability, and economic disruption. Cancer, the second-leading cause of death worldwide, is indicative of this complex and multifaceted challenge, with its health and economic costs expected to intensify over the coming decades. By 2050, studies project that escalating incidence of cancer will result in more than 35 million cases annually. Each one of these cases represents far more than one premature death—it entails sacrificed quality of life, increased disability, disrupted learning, lost economic opportunity, and familial hardship.

The upward trend in cancer incidence is driven by a mix of demographic, behavioral, social, genetic, and environmental factors. Cancer is closely correlated with aging and behavioral choices such as meat consumption and tobacco and alcohol use, all of which increase within populations as countries develop and income levels rise. At the same time, environmental factors such as exposure to pollutants and carcinogenic material, poor air quality, and increased ultraviolet radiation all increase the risk of cancer, entangling trends such as urbanization, industrialization, and climate change with rising cancer rates. While rising cancer rates will continue to pose a challenge to HICs, LMICs will experience disproportionate increases in the coming decades, particularly as they will be home to an estimated 80 percent of people over 60 by 2050. These countries are simultaneously set to experience the biggest increases in cancer burden while remaining the least prepared in terms of health care capacity.

Trends in four major cancers—lung, breast, cervical, and colorectal—help illustrate the growing health care burden posed by cancer. Together, these four cancers accounted for about 36.8 percent of global cancer incidence and 38.3 percent of cancer mortality in 2022. Across these cancers, cumulative new cases are expected to rise from 7.4 million in 2022 to 12.7 million by 2050, resulting in an estimated 7 million deaths annually. Much of this growing cost, in terms of both prevalence and mortality, will fall on LMICs.

Colorectal cancer incidence rates, for example, are expected to increase by 26 percent in HICs between 2022 and 2050, compared to 209 percent in LMICs. Lung cancer, responsible for nearly a fifth of all cancer deaths globally, is predominantly driven by tobacco consumption, and over 80 percent of smokers today live in LMICs, including over 300 million in China alone. In terms of mortality, patients in LMICs commonly face worse outcomes than those in HICs. HICs have a five-year survival rate for breast cancer of more than 90 percent, compared to 66 percent in India and 40 percent in South Africa. Likewise, 90 percent of cervical cancer deaths today occur in LMICs, with a mortality rate of around 60 percent. This is nearly double the mortality rate in HICs, some of which are well on the way to eradicating cervical cancer.

Incidence Rates of Lung, Breast, Cervical, and Colorectal Cancers

Cancer’s impact will be felt unevenly, concentrated in LMICs, where health care systems are broadly under-prepared and under-resourced to provide adequate cancer diagnosis, care, and treatment, and investments to operationalize cancer mitigation policies lag need.

DATA SOURCe: Global Cancer Observatory

The human costs of cancer—nearly 10 million lives lost annually—are further intensified by the direct economic costs resulting from sickness, disability, treatment, care, and lost productivity from patients and caregivers alike. All cancers, taken together, are anticipated to cost the world USD 25.2 trillion between 2020 and 2050, equivalent to a 0.55 percent tax on annual global domestic product. These costs are derived from increased rates of sickness, lower quality of life, reduced participation in the workforce, lower income generation, and shortened life expectancy. When measured in disability-adjusted life years (DALYs)—a common metric used to measure years lost to disability and premature death—lung, breast, cervical, and colorectal cancers alone had an estimated burden of 1,170.2 DALYs per 100,000 people globally in 2021. Put another way, these four cancers are responsible for 96 million lost years of healthy, productive life globally every year.

The true scope of cancer’s costs remains impossible to measure fully. For each case of cancer, there are hard-to-track costs, such as thousands of hours of informal care (often by women unpaid for their time), instances of foregone educational or professional opportunities, and diffuse mental health impacts across families and other caregivers. Each aspect of the disease’s costs has the potential to impact both the well-being and productivity of numerous individuals, their families, and their descendants. Improved cancer care is therefore a global imperative, driven by the returns of healthy lives and averted medical costs for patients and society at large alongside greater economic productivity and growth.

Cancer care policies and interventions are uneven cross- and sub-nationally, and wholly inadequate to prevent and manage current and future impacts.

Given the clear health and economic costs of cancer, the global community has elevated the disease as a health priority in recent decades. Domestically, countries have targeted cancer through national cancer control plans (NCCPs). These plans lay out an overarching policy strategy for preventing and addressing cancer cases, with the most comprehensive versions covering all aspects of care, including prevention, early detection, diagnosis, treatment, palliative care, patient support, caregivers, and beyond. Globally, 121 countries had an NCCP registered with the International Cancer Control Partnership as of 2023. These plans are buttressed internationally by numerous multilateral initiatives to catalyze greater action on cancer, such as various efforts from the World Health Organization and the Union for International Cancer Control (UICC), as well as individual country and regional strategies like Europe’s Beating Cancer Plan and the United States’ Cancer Moonshot.

Public-private partnerships also have a productive role to play in galvanizing innovation and investment toward cancer care. C/CAN, for example, launched by UICC at the World Economic Forum in 2017, partners with city governments, especially in LMICs, to expand equitable access to cancer care by bringing together networks of policymakers, health care providers, and patients. The spectrum of such efforts is designed to marshal resources on a greater scale to support cancer interventions, share best practices, catalyze research and drug development, and build political will for continued action. Yet, their resourcing and implementation remain slow and uneven, contributing to stymied progress. Indeed, cancer response remains bifurcated globally, with policy priorities still poorly defined in many countries or beholden to resource constraints across high-, middle-, and low-income contexts.

Despite the growing prevalence of NCCPs, many countries have plans that are far from comprehensive, leaving essential elements of care unaddressed or unfunded. Producing a context-specific NCCP that acknowledges the varied cancer burden in different contexts, accounting for differences in demographics, consumption patterns, health care access, social circumstances, and other considerations, is a resource-intensive task that many lower-income states do not have resources to produce. Indeed, just 32 percent of LMICs and 24 percent of LICs have population-based cancer registries, making the true scope of the cancer burden opaque to policymakers and health care practitioners. There is also no one-size-fits-all policy approach to addressing cancer, further complicating the challenge of building and implementing appropriate policies.

Vast disparities exist among the health care systems of HICs and LMICs, and even among the rich and poor communities within HICs and LMICs themselves, generally driven by disparities in health care spending. This results in divergent health outcomes even when sound policies are in place. In a WHO survey of 115 countries, 39 percent included basic cancer care as part of their financed care offered to all citizens, and only 28 percent covered palliative care. Similarly, a Lancet Oncology study found that only 10 percent of reviewed NCCPs included detailed budget plans, a pattern documented elsewhere of public health or other policy plans being disconnected from fiscal realities. This has enormous implications for the future of cancer care: LMICs account for 80 percent of disease burden globally but just 5 percent of cancer care spending.

Ninety percent of people in HICs have access to comprehensive cancer care, compared to less than 15 percent in LICs, and fully three-quarters of individuals in LICs have no access to basic cancer diagnostic and treatment services. In the case of cervical cancer, the lifetime screening rates in Sweden and the Netherlands are nearly 100; in Ethiopia, it is just 4 percent. Such stark contrasts are all too common, but differences in outcomes can also be seen sub-nationally in both LMICs and HICs. In the United States, for instance, Black people are more than twice as likely to die from prostate cancer than white individuals and 42 percent more likely to die from breast cancer.

Such disparities can be observed across all aspects of cancer-related care, from access to early, high-quality screening, to sustaining a qualified workforce, to investments in research. In terms of screening for breast cancer, for example, countries in North America and Europe have an average of 15 mammography units and more than 100 radiologists per million people, compared to fewer than five mammography units and 10 radiologists per million people on average across African countries. With an expected general shortfall of 18 million health care workers globally by 2030, and many medical professionals preferring to work in wealthy countries, where salaries are higher, the shortage in medical personnel in LMICs will only intensify. And while advancements in treatment in HIC contexts offer value globally, such as through the dissemination of biosimilar and generic drugs, research is too often focused on HIC contexts, often due to limited infrastructure and inadequate investment elsewhere. Just 8 percent of all stage-3 trials for anti-cancer therapeutics between 2014 and 2017 were conducted within LMICs, despite these countries representing the overwhelming majority of cancer cases.

Stakeholder networks can work to unlock the cascading health, development, and economic benefits of cancer care.

Despite the large scope of the cancer burden and the major disparities in cancer care outcomes globally, countries around the world are demonstrating the efficacy of comprehensive cancer policies when backed by sustained financial commitments. Several HICs are leading the way in building effective policies that cover virtually all aspects of cancer care, from prevention to palliative care, that are producing tangible results today. For example, the five-year survival rate for all types of cancer in Australia has improved from 53 percent between 1990 and 1994 to 71 percent between 2015 and 2019. Moreover, the country’s flagship cancer plan has outlined its strategy for, among other things, eliminating cervical cancer by 2035, well ahead of the WHO’s aspiration to eliminate the disease globally by 2120. Similar improvements in the rate of cancer survivorship can be seen globally, including in Ireland, South Korea, and the United States. A range of less-wealthy countries—such as Kenya, Mexico, Morocco, Panama, and Peru—have indicated their intent to follow suit by producing extensive cancer care plans of their own, though many of these lack explicit funding commitments. The future success of such policy programming depends both on adapting effective tools and devoting ample funding to see those interventions through to fruition.

As a part of these efforts, private-sector companies and civil society groups have important roles to play as convenors, investors, and providers of quality, accessible care. For example, more than half of cancer drugs on the WHO Model Lists of Essential Medicines are not available in LMICs. The Access to Oncology Medicines (ATOM) Coalition, bringing together the expertise of pharmaceutical companies, NGOs, and other partners, seeks to address this imbalance by improving cancer care infrastructure, developing in-country expertise, and expanding access to generics and biosimilars in 46 LMICs. This work includes encouraging continued production of new medicines, with accessibility as a top priority alongside centering patient voices to anticipate and mitigate socio-cultural, financial, and systemic barriers to care.

Underlying the positive potential impact of public and private action against cancer is a host of established cancer-intervention strategies that are shown to deliver life-saving results. Indeed, 70 percent of common cancers in LMICs have proven prevention, screening, and early-detection interventions. The greatest potential gains begin with preventative policies that avert or reduce the risk of cancer cases. Cancer prevalence, alongside the prevalence of other NCDs, can be significantly reduced through behavior change to limit risk factors, such as through government policies that encourage smoking cessation, lower sugar and alcohol consumption, and limit indoor air pollution. Indeed, four in ten cancer cases can be avoided by behavioral changes, some of which are being successfully implemented globally. For example, the WHO’s MPOWER tobacco control measures are estimated to have stopped 300 million people from becoming smokers in the last 15 years, thus mitigating the top cause of lung cancer, which kills 1.8 million people annually around the world.

Cancer treatment is also far more effective in most cases when the disease is detected and treated early, making a strong argument for proactive screening programs and investments in diagnostic capacity. For example, in the case of breast cancer in the United Kingdom, five-year survival rates are nearly 100 percent if the disease is detected in Stage 1, but can be just 25 percent if detected in Stage 4. Established cancer interventions also offer enormous potential gains in the long term. In the case of cervical cancer, the WHO estimates that achieving its 90-70-90 targets for cervical cancer care could avert 62 million deaths by 2120 and virtually eliminate cervical cancer risk.

Importantly, beyond their medical efficacy, the direct and indirect economic benefits of many cancer interventions also outweigh their costs, making a clear case for stronger investment. Some of these opportunities start with strategies to counteract NCDs generally. The WHO Best Buys—which include interventions to reduce tobacco use, alcohol consumption, unhealthy diets, and physical inactivity—are estimated to return seven dollars in benefits for every dollar invested in low- and lower-middle-income countries, derived from restored years of healthy life and reduced medical costs. Similar cost-based arguments can be made for investments in early screening and diagnostics for cancer as well as improved treatment options. Cancer care for those diagnosed early is two to four times cheaper, on average, than treatment at more advanced stages. Likewise, in a study of 11 cancers (including breast, lung, cervical, and colorectal), there was an estimated return on investment (ROI) of over twelve dollars for every dollar spent on treatment, imaging, and quality care.

There are many other cascading benefits to better cancer care that offer potential cost savings, such as averted or reduced mental illness. In the United States, newly onset anxiety and depression, which impact a third of Medicare beneficiaries with cancer, are associated with USD 17,496 in additional health care costs annually per patient. The potential benefits of more effective, affordable cancer treatment or more averted cases can spread across communities, such as through reduced mental illness in family members and caregivers, delivering widespread and hard-to-estimate benefits. Collectively, the potential gains from financing cancer care, especially lower-cost interventions in LMICs, make a compelling economic case for greater investment in cancer control and prevention.

A Clear Economic Case for Investment in Scaling Up Cancer Care

When assessed by return on investment (ROI) metrics, spending across a spectrum of cancer interventions yields several times more in direct and indirect benefits to patients and society, making them financially sensible.

Note: ROI metrics measure the estimated dollar value of anticipated benefits per dollar invested.

Sources: Lancet Oncology, BMC Health Services Research, WHO, Cancer Research UK, JTO Clinical and Research Reports

Concerted multistakeholder actions can reduce the growing cancer burden while expanding care and supporting healthier societies.

The risk of inaction is too great to forego greater policy prioritization of, and investment in, cancer care. Existing interventions and cancer care strategies have demonstrated ability to reduce incidence rates, mortality, sickness times, demands on caregivers and family, and burden on communities and economies. Critically, many of these approaches also represent sound economic investments for countries globally, with anticipated direct and indirect benefits to patients and society often outstripping cost of initial investment.

The public and private sectors need to move toward an inclusive roadmap to expand and better integrate cancer-mitigation efforts across the national, regional, and global levels. The advances in cancer care in recent decades, while promising, are still deeply uneven among, and within, wealthy and developing countries. That cervical cancer is close to being virtually eliminated in HICs while it remains the leading cause of cancer death among women in 37 LMICs is a clear sign of misaligned priorities, inadequate organization and political will, and insufficient investment. To better align and achieve progress, policymakers, investors, innovators, and health care providers need to elevate cancer care within their agendas, ensuring that the issue remains front of mind as a key component of improving health outcomes globally and achieving benchmark development goals, such as UN SDG 3.4 (reducing premature mortality from NCDs). Intermediaries, including NGOs, private health companies, and multilateral development banks, can help ensure that countries everywhere have the tools, knowledge, resources, and exchanges necessary to develop NCCPs to yield sustained progress in the fight against cancer.

To maximize the potential of cancer care globally, the following priorities deserve greater policy attention and expanded fiscal resources, domestically and internationally:

• Implement proven, high-impact interventions that benefit large numbers of patients. Relatively simple intervention strategies, from limiting risk factors such as smoking and alcohol consumption to enabling frequent screening for high-risk populations, are demonstrated to yield substantial positive benefits both in reducing and averting sickness and saving medical costs. Expanding access to vaccination, screening, and treatment for cervical cancer in particular should be a top priority, given the high efficacy and relatively low cost of treatment.
• Prioritize targeted and inclusive policy planning. As of 2023, over 70 countries did not have an NCCP. Many lack the capacity to fully develop plans that capture and account for the local context of the cancer burden, due to limited data and health care infrastructure. Enabling robust data collection across country contexts and better equipping countries with the means to formulate context-sensitive plans can help ensure development of effective frameworks for more effective cancer care and prevention.
• Fund policies and monitor implementation. Countries must pair robust policy agendas with budgetary commitments to effectively deliver needed health care services. Where gaps persist, donor countries, international finance institutions, and multilateral groupings should leverage resources to catalyze change, prioritizing high-risk populations and interventions with compounding benefits for other health and development goals, such as combatting NCDs.
• Elevate patient perspectives in policy design and program evaluation. Key to effective care and policy is consistent acknowledgment and mindfulness of patient experiences. In addition to robust data, knowledge of personal stories and community-specific circumstances can help ensure that care effectively meets all patients where they are and avoids leaving marginalized populations with partial access to life-saving cancer interventions.
• Improve access to quality, timely cancer care—for everyone. Local, regional, and international stakeholders must work to mitigate the grave disparities in access to basic cancer care. A range of health, economic, and rights-based development goals will remain out of reach if countries around the world lack access to effective health care services for addressing the world’s second-leading cause of death.

While the health, social, and economic costs of cancer are rising, a multistakeholder approach built on sound policy and sustained financial investment can effectively deter this trend, restoring years of healthy, productive life to millions around the world, and underpinning a prosperous global future.

Publication date: January 2025

By Phillip Meylan (Affiliate Researcher) and Isabel Schmidt (Senior Policy Analyst and Research Manager).

An issue brief by FP Analytics, the independent research division of The FP Group, produced with financial support from Pfizer. FP Analytics retained control of the research direction and findings of this issue brief. Foreign Policy’s editorial team was not involved in the creation of this content.