Global cancer surgery: delivering safe, affordable, and timely cancer surgery

Richard Sullivan; Olusegun Isaac Alatise; Benjamin O Anderson; Riccardo Audisio; Philippe Autier; Ajay Aggarwal; Charles Balch; Murray F Brennan; Anna Dare; Anil D'Cruz; Alexander M M Eggermont; Kenneth Fleming; Serigne Magueye Gueye; Lars Hagander; Cristian A Herrera; Hampus Holmer; André M Ilbawi; Anton Jarnheimer; Jia-Fu Ji; T Peter Kingham; Jonathan Liberman; Andrew J M Leather; John G Meara; Swagoto Mukhopadhyay; Shilpa S Murthy; Sherif Omar; Groesbeck P Parham; C S Pramesh; Robert Riviello; Danielle Rodin; Luiz Santini; Shailesh V Shrikhande; Mark Shrime; Robert Thomas; Audrey T Tsunoda; Cornelis van de Velde; Umberto Veronesi; Dehannathparambil Kottarathil Vijaykumar; David Watters; Shan Wang; Yi-Long Wu; Moez Zeiton; Arnie Purushotham

doi:10.1016/S1470-2045(15)00223-5

Global cancer surgery: delivering safe, affordable, and timely cancer surgery

Richard Sullivan, Olusegun Isaac Alatise, Benjamin O Anderson, Riccardo Audisio, Philippe Autier, Ajay Aggarwal, Charles Balch, Murray F Brennan, Anna Dare, Anil D'Cruz, Alexander M M Eggermont, Kenneth Fleming, Serigne Magueye Gueye, Lars Hagander, Cristian A Herrera, Hampus Holmer, André M Ilbawi, Anton Jarnheimer, Jia-Fu Ji, T Peter KinghamJonathan Liberman, Andrew J M Leather, John G Meara, Swagoto Mukhopadhyay, Shilpa S Murthy, Sherif Omar, Groesbeck P Parham, C S Pramesh, Robert Riviello, Danielle Rodin, Luiz Santini, Shailesh V Shrikhande, Mark Shrime, Robert Thomas, Audrey T Tsunoda, Cornelis van de Velde, Umberto Veronesi, Dehannathparambil Kottarathil Vijaykumar, David Watters, Shan Wang, Yi-Long Wu, Moez Zeiton, Arnie Purushotham

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Abstract

Surgery is essential for global cancer care in all resource settings. Of the 15·2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$6·2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

Original language	English
Pages (from-to)	1193-224
Number of pages	32
Journal	The Lancet Oncology
Volume	16
Issue number	11
Early online date	1 Sept 2015
DOIs	https://doi.org/10.1016/S1470-2045(15)00223-5
Publication status	Published - 1 Sept 2015

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Sullivan, R., Alatise, O. I., Anderson, B. O., Audisio, R., Autier, P., Aggarwal, A., Balch, C., Brennan, M. F., Dare, A., D'Cruz, A., Eggermont, A. M. M., Fleming, K., Gueye, S. M., Hagander, L., Herrera, C. A., Holmer, H., Ilbawi, A. M., Jarnheimer, A., Ji, J.-F., ... Purushotham, A. (2015). Global cancer surgery: delivering safe, affordable, and timely cancer surgery. The Lancet Oncology, 16(11), 1193-224. https://doi.org/10.1016/S1470-2045(15)00223-5

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title = "Global cancer surgery: delivering safe, affordable, and timely cancer surgery",

abstract = "Surgery is essential for global cancer care in all resource settings. Of the 15·2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$6·2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.",

author = "Richard Sullivan and Alatise, {Olusegun Isaac} and Anderson, {Benjamin O} and Riccardo Audisio and Philippe Autier and Ajay Aggarwal and Charles Balch and Brennan, {Murray F} and Anna Dare and Anil D'Cruz and Eggermont, {Alexander M M} and Kenneth Fleming and Gueye, {Serigne Magueye} and Lars Hagander and Herrera, {Cristian A} and Hampus Holmer and Ilbawi, {Andr{\'e} M} and Anton Jarnheimer and Jia-Fu Ji and Kingham, {T Peter} and Jonathan Liberman and Leather, {Andrew J M} and Meara, {John G} and Swagoto Mukhopadhyay and Murthy, {Shilpa S} and Sherif Omar and Parham, {Groesbeck P} and Pramesh, {C S} and Robert Riviello and Danielle Rodin and Luiz Santini and Shrikhande, {Shailesh V} and Mark Shrime and Robert Thomas and Tsunoda, {Audrey T} and {van de Velde}, Cornelis and Umberto Veronesi and Vijaykumar, {Dehannathparambil Kottarathil} and David Watters and Shan Wang and Yi-Long Wu and Moez Zeiton and Arnie Purushotham",

year = "2015",

month = sep,

day = "1",

doi = "10.1016/S1470-2045(15)00223-5",

language = "English",

volume = "16",

pages = "1193--224",

journal = "The Lancet Oncology",

issn = "1470-2045",

publisher = "Lancet Publishing Group",

number = "11",

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Sullivan, R, Alatise, OI, Anderson, BO, Audisio, R, Autier, P, Aggarwal, A, Balch, C, Brennan, MF, Dare, A, D'Cruz, A, Eggermont, AMM, Fleming, K, Gueye, SM, Hagander, L, Herrera, CA, Holmer, H, Ilbawi, AM, Jarnheimer, A, Ji, J-F, Kingham, TP, Liberman, J, Leather, AJM, Meara, JG, Mukhopadhyay, S, Murthy, SS, Omar, S, Parham, GP, Pramesh, CS, Riviello, R, Rodin, D, Santini, L, Shrikhande, SV, Shrime, M, Thomas, R, Tsunoda, AT, van de Velde, C, Veronesi, U, Vijaykumar, DK, Watters, D, Wang, S, Wu, Y-L, Zeiton, M & Purushotham, A 2015, 'Global cancer surgery: delivering safe, affordable, and timely cancer surgery', The Lancet Oncology, vol. 16, no. 11, pp. 1193-224. https://doi.org/10.1016/S1470-2045(15)00223-5

TY - JOUR

T1 - Global cancer surgery

T2 - delivering safe, affordable, and timely cancer surgery

AU - Sullivan, Richard

AU - Alatise, Olusegun Isaac

AU - Anderson, Benjamin O

AU - Audisio, Riccardo

AU - Autier, Philippe

AU - Aggarwal, Ajay

AU - Balch, Charles

AU - Brennan, Murray F

AU - Dare, Anna

AU - D'Cruz, Anil

AU - Eggermont, Alexander M M

AU - Fleming, Kenneth

AU - Gueye, Serigne Magueye

AU - Hagander, Lars

AU - Herrera, Cristian A

AU - Holmer, Hampus

AU - Ilbawi, André M

AU - Jarnheimer, Anton

AU - Ji, Jia-Fu

AU - Kingham, T Peter

AU - Liberman, Jonathan

AU - Leather, Andrew J M

AU - Meara, John G

AU - Mukhopadhyay, Swagoto

AU - Murthy, Shilpa S

AU - Omar, Sherif

AU - Parham, Groesbeck P

AU - Pramesh, C S

AU - Riviello, Robert

AU - Rodin, Danielle

AU - Santini, Luiz

AU - Shrikhande, Shailesh V

AU - Shrime, Mark

AU - Thomas, Robert

AU - Tsunoda, Audrey T

AU - van de Velde, Cornelis

AU - Veronesi, Umberto

AU - Vijaykumar, Dehannathparambil Kottarathil

AU - Watters, David

AU - Wang, Shan

AU - Wu, Yi-Long

AU - Zeiton, Moez

AU - Purushotham, Arnie

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Surgery is essential for global cancer care in all resource settings. Of the 15·2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$6·2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

AB - Surgery is essential for global cancer care in all resource settings. Of the 15·2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$6·2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

U2 - 10.1016/S1470-2045(15)00223-5

DO - 10.1016/S1470-2045(15)00223-5

M3 - Article

C2 - 26427363

SN - 1470-2045

VL - 16

SP - 1193

EP - 1224

JO - The Lancet Oncology

JF - The Lancet Oncology

IS - 11

ER -

Global cancer surgery: delivering safe, affordable, and timely cancer surgery

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