Global Oncology Gaps Highlight Barriers to Equitable Cancer Care

At the 2026 NCCN Annual Conference, global oncology discussions emphasized the intersection of social determinants of health and cancer care delivery.

Caroline Taylor, founder and executive director of Global Focus on Cancer, outlined how gaps in primary care education, limited oncology infrastructure, and caregiver burden collectively impact patient adherence and outcomes, particularly in low- and middle-income countries.

Oncology Nursing News: What were some of the major themes discussed at the 2026 NCCN Annual Conference?

Taylor: It was a session on global oncology and global cancer. We talked quite a bit about policy and the challenges in policy right now. We all introduced kind of what we do. I was the only non-oncologist on the panel, working in supportive care and the work that we do regarding the challenges that people face, in low- and middle-income countries.

We discussed late diagnosis, difficult pathways to treatment, caregiver burden on families, financial catastrophe, and the difficulties for people navigating cancer with limited resources, both when they are waiting to be diagnosed or once they enter the system. And then we talked about what the policy implications are for that. I know you can edit, so I'm not worried; I'm just trying to think what the questions were. We discussed what NCCN’s value is in their global work and how that's relevant in the context of what all of us do, and then also what people at the conference could do to help in other countries as well.

How do global disparities affect patient outcomes?

It really depends on where you live, right? And it's not just where you live, but what your resource level is. It's always an equity issue, and those are really challenging. You might live in a low-resource setting, but you might have finances, so you might be okay. But if you live in a low-resource setting and you're a farmer or you don't have access to care, primary healthcare doesn't necessarily have great links to oncology care.

Oncology care is often quite centralized, and people don't have access to those services, so people often present at late stages. This is due to a lack of linkages and a lack of knowledge in the primary healthcare setting about cancer. People may present with symptoms, but on the primary care level, doctors don't always have great awareness of the signs and symptoms of cancer, so they're not sure what to do with them or how to send them on for further care. Consequently, their presentation becomes delayed.

There is also a lack of workforce capacity. The first time I went to Tanzania in 2011, there were four oncologists in the entire country for 45 million people. You can imagine what happens then. Two radiation machines were running 24/7. It is a really challenging situation for people. Cancer care often isn't covered, leading to financial difficulties. Furthermore, workforce capacity issues mean that families have to come with the patient to help care for them, feed them, and keep them clean. Then the family is out of work as well.

It's a big cycle of social determinants of health, caregiving responsibilities for family members, and your own responsibilities to work. It influences everything. Cancer doesn't happen in a bubble; it happens in this broad spectrum of how we live in communities, in society, and in our workplaces. That is a lot of what our work tries to get to, as opposed to the actual clinical care. What we try to do is help people access care, stay in care, and complete their care, because that often determines if someone survives or not.

Are there any solutions that you want to shout out that are being proposed or worked on to address these challenges?

For us, we find incredible value in lived experience. We have a model of peer-to-peer support that we've developed and built a toolkit around. We ran an NCI-funded clinical trial in Vietnam on this in 2021 and 2022 during COVID, and we had great statistical results. We ran the trial with women with breast and gynecologic cancers at four sites in Vietnam. We helped them adhere to treatment, understand it, reduce their distress and anxiety, and improve their quality of life.

It also showed improved self-esteem for the peer mentors. Improving their reflections on their own cancer experience gave them a new sense of purpose. We developed a toolkit to guide the implementation of this program and just wrapped a trial in Rwanda where we had incredible, statistically significant results. I think capitalizing on lived experience, having that person who has been through that cancer and has walked that path help someone newly diagnosed, is incredibly valuable. I don't think people realize how something so small can be so beneficial in helping people navigate the emotional and physical way through cancer care in an empowered way.

What role do patients play in shaping future strategies, based on what we were just talking about?

Patients are people with lived experience. I always define it that way because I haven't been a "patient" for 20 years. I take it out of the bubble of "patient." I think people with lived experience have an enormous role in helping newly diagnosed patients get through, in advocating in every aspect of cancer care, and in developing research, policy, and implementation.

A lot of our work is research; we do research around everything that we do. We have a program right now where we work very closely with City Cancer Challenge, which looks at how to improve cancer services in low- and middle-income countries on a city level. We have a pilot in three cities: León, Mexico; Nairobi, Kenya; and Tbilisi, Georgia. We are looking at what a gender-responsive framework looks like for women with cancer. It's based on the Lancet Commission on Women, Power, and Cancer that I was a part of.

In each city, we have an academic partner, and we've embedded a person with lived experience in each of the research teams as an active member. We're actually measuring the impact of that person. It was really exciting because this week, the León team presented in our weekly research meeting and said that this was maybe the most valuable part of the work to date. It gave them a level of understanding of cancer that they wouldn't have had without having that person with lived experience involved in the work.

What would you like readers to take away from this conversation today?

I think this meeting can be a very valuable resource for the patient and patient advocate community. Regarding the guidelines in particular, there's a lot of opportunity for input from people with lived experience. NCCN is very open to that. I think they want partnership. It's our own experiences that can really help guide the future of what the guidelines look like, improve services, improve access to care, and help with navigating care. It's so important for those of us with lived experience to attend meetings like this to have a voice and a presence.

I really want to thank NCCN for putting me on the plenary and having a person with lived experience in that role, rather than just having all clinicians. It's a very valuable space.

Transcript has been edited for clarity and conciseness.