Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide.

The first Lancet Oncology Commission on Global Cancer Surgery was published in 2015 and serves as a landmark paper in the field of cancer surgery. The Commission highlighted the burden of cancer and the importance of cancer surgery, while documenting the many inadequacies in the ability to deliver safe, timely, and affordable cancer surgical care. This Commission builds on the first Commission by focusing on solutions and actions to improve access to cancer surgery globally, developed by drawing upon the expertise from cancer surgery leaders across the world. We present solution frameworks in nine domains that can improve access to cancer surgery. These nine domains were refined to identify solutions specific to the six WHO regions. On the basis of these solutions, we developed eight actions to propel essential improvements in the global capacity for cancer surgery. Our initiatives are broad in scope, pragmatic, affordable, and contextually applicable, and aimed at cancer surgeons as well as leaders, administrators, elected officials, and health policy advocates. We envision that the solutions and actions contained within the Commission will address inequities and promote safe, timely, and affordable cancer surgery for every patient, regardless of their socioeconomic status or geographic location.

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Declaration of interests CA holds a patent for a laparoscopic instrument with the University of Nebraska, and serves in leadership positions and committees in the Society of Surgical Oncology, American College of Surgeons, Indian Association of Surgical Oncology, The Global Forum of Cancer Surgeons, Basavatarakam Indo-American Cancer Hospital and Research Institute, National Cancer Institute, National Comprehensive Cancer Network, and Accreditation Council for Graduate Medical Education. SC's current affiliation is Janssen (Boston, MA, USA) where he began work in June, 2022. MT received grants and contracts from Chugai, Takeda, Pfizer, Taiho, Japan Breast Cancer Research Group, Kyoto Breast Cancer Research Network, Eisai, Eli Lilly and Company, Daiichi Sankyo, AstraZeneca, Astellas, Shimadzu, Yakult, Nippon Kayaku, AFI Technology, Luxonus, Shionogi, GL Sciences, and Sanwa Shurui; payments or honoraria from Chugai, Takeda, Pfizer, Kyowa–Kirin, Taiho, Eisai, Daiichi Sankyo, AstraZeneca, Eli Lilly and Company, MSD, Exact Science, Novartis, Shimadzu, Yakult, Nippon Kayaku, Devicore Medical Japan, and Sysmex; participates in the data safety monitoring board or advisory board of Daiichi Sankyo, Eli Lilly and Company, BMS, Athenex Oncology, Bertis, Terumo, and Kansai Medical Net; and serves as an Associate Editor for British Journal of Cancer, Scientific Reports, Breast Cancer Research and Treatment, Cancer Science, Frontiers in Oncology, Asian Journal of Surgery, and Asian Journal of Breast Surgery. LN received honoraria for speaking and educational events from Duke University, University of Chicago, Dana-Farber Cancer Institute, Mayo Clinic Jacksonville, BioAscend, MJH Healthcare Holdings, Society of Surgical Oncology, and American Cancer Society; serves on the Johns Hopkins Data Safety Monitoring Board for KALPAS Study and Duke University Cancer Center SPORE External Advisory Board; holds leadership roles in the Board of Directors, American Association for Cancer Research (unpaid/non-salaried), Board of Directors, SHARE Cancer Patient Support Organization (unpaid/non-salaried), and the Susan G Komen Scientific Advisory Board (unpaid/non-salaried). HM-S received payment or honoraria from Merck and Bristol Myers Squibb. AFR served as a co-lead of the implementation group of WHO's Global Breast Cancer Initiative, and has stock units as an employee of Hologic. ITR received honoraria from AstraZeneca and MSD. All other authors declare no competing interests.