The research was conducted by a team affiliated with the Lancet Oncology Commission on the Human Crisis in Cancer, an initiative launched to quantify and correct the growing imbalance between biomedical investment and the human dimensions of oncology. Using data from the 2023 global review by the International Cancer Control Partnership, the researchers screened a standardized questionnaire of 95 items and identified 20 questions relevant to five Commission domains: compassionate care models, human-centred metrics, equitable access to psychosocial and palliative services, workforce and education reform, and value-aligned governance. Those items were then mapped into six analytical themes spanning sociocultural factors, systems of care, medical education, economic protection, mental health and palliative care.

The single most striking finding concerns who gets a seat at the table. Although 93 percent of the plans reported that stakeholders were involved in their development, only 12 percent identified people living with cancer as stakeholders. Governmental, professional and institutional actors dominate cancer planning almost everywhere, meaning the very documents that set national priorities rarely reflect the priorities of the people they are meant to serve. The authors point to power imbalances, funding and time constraints, and simple lack of awareness as likely barriers, and note that World Health Organization guidance explicitly calls for engaging patient groups in national cancer control planning.

The income gradient in the data is stark. On average, human-centred themes appeared in 44 percent of plans from upper-middle and high-income countries but only 32 percent of plans from lower-middle and low-income countries. Medical education was the exception that proved the rule: 96 percent of countries with dedicated cancer plans included workforce development or provider training, with no significant difference between income groups. But the content of that training was overwhelmingly biomedical. Oncologists, pathologists and surgical specialists featured prominently, while psychosocial support training appeared in just 16 percent of plans, community health worker training in 12 percent, and patient navigator training in a mere 4 percent.

Economic protection emerged as perhaps the most neglected theme of all. Only 13 percent of plans included strategies to shield patients from catastrophic health expenditure — typically defined as spending more than 30 percent of household income on cancer-related costs — and the figure was essentially flat across income levels, with high-income countries actually among the least likely to include such provisions. Universal health coverage strategies appeared in just 26 percent of plans overall. Given that financial toxicity is a well-established driver of cancer inequity, treatment abandonment and poorer outcomes, the authors argue that this neglect represents a fundamental misalignment between policy and patient need.

Mental health provisions fared little better. While 72 percent of countries with cancer plans included strategies to support families or caregivers of patients in active treatment, only 3 percent of all plans referenced essential medicines for treating psychological distress such as anxiety, depression and delirium — the least frequently included item in the entire analysis. Post-treatment survivorship care appeared in 80 percent of high-income country plans but only 25 percent of low-income country plans, a difference that was highly statistically significant. This gap is particularly concerning given the documented burden of depression among cancer patients, which is highest on the African continent at a pooled prevalence of 35 percent, compared with 25 percent in North America, and given established links between psychological distress, quality of life, treatment adherence and survival.

Palliative care was the strongest-performing human-centred theme, appearing in an average of 65 percent of plans, with pain management strategies present in 62 percent and no significant income-based differences. Yet even here the picture is incomplete: patient navigation — the practice of guiding patients through screening, treatment, financial assistance and supportive services — was included in 42 percent of plans overall but dropped to around 11 percent in lower-income settings, precisely where late-stage presentation is most common and navigation may deliver the greatest benefit. In many African countries, up to 80 percent of patients present with locally advanced or metastatic disease at diagnosis, making supportive and navigational infrastructure not a luxury but a necessity.

The authors are careful to spell out what their analysis can and cannot show. Roughly 18 percent of WHO Member States lacked publicly available plans, and the study measured policy intent rather than implementation, funding or patient outcomes. A plan’s silence on psychosocial care does not prove the absence of services, since mental health or financial protection may be addressed through separate national health or universal coverage policies. Countries were weighted equally regardless of population, so the figures describe the proportion of countries rather than the proportion of people covered. In conflict-affected states, a plan can look comprehensive on paper while the health system it describes barely functions. Still, the consistency of the gaps across regions and income levels suggests a genuine structural blind spot rather than a documentation artifact.

The study’s conclusions align with the Commission’s broader call to rehumanize cancer care. Its recommendations include embedding scalable patient navigation — particularly financial navigation — into national plans, strengthening structural supports for caregivers, guaranteeing access to essential psychotropic medicines, reforming workforce training to include psychosocial competencies, and shifting governance toward value-aligned, equity-oriented models. The authors also propose that future iterations of the assessment instrument move beyond binary yes-or-no questions to capture whether commitments are actually costed, assigned to an agency, implemented and monitored, with equity-stratified indicators and patient-reported experience measures built in.

What makes the findings resonate beyond oncology is what they reveal about how health systems value intangible goods. Machines, drugs and screening programs are easy to cost, procure and count; compassion, dignity and psychological safety are not. The analysis suggests that unless national strategies explicitly name and resource the human dimensions of cancer care, those dimensions will continue to lose out in budget negotiations and implementation plans — and the patients who bear the heaviest burden of advanced disease, poverty and psychological distress will continue to be the least likely to receive them. The authors’ message to policymakers is blunt: a cancer strategy that plans only for the tumor, and not for the person, is an incomplete strategy.

Subject of Research: Global policy analysis of human-centred cancer care in national cancer strategy plans

Article Title: A cross-sectional global policy analysis of the human gap in 156 national cancer strategy plans

Article References: Lau, E., Shapiro, G. K., Rodin, G., Sullivan, R., Bhoo-Pathy, N., Unger-Saldaña, K., Trapani, D., Salins, N., Skelton, M., & Li, M. (2026). A cross-sectional global policy analysis of the human gap in 156 national cancer strategy plans. eClinicalMedicine, 100, Article 104244. https://doi.org/10.1016/j.eclinm.2026.104244

Image Credits: AI Generated

DOI: 10.1016/j.eclinm.2026.104244

Keywords: national cancer control plans, human-centred care, psychosocial support, palliative care, patient navigation, health equity, financial protection, mental health, cancer policy, low-income countries, Lancet Oncology Commission, eClinicalMedicine