Bridging Global Gaps in Cancer Care Access and Support

Access to cancer care remains a significant global challenge, with many disparities in care affecting millions of patients worldwide. Although some barriers mirror those seen in the United States, such as financial toxicity and limited access to care, many regions face additional hurdles, including lack of insurance and insufficient survivorship resources.

During the 2026 NCCN Annual Conference, Dr. Anurag K. Agrawal, a pediatric hematologist-oncologist and vice president of Global Cancer Support at the American Cancer Society shared his insights on the topic during a plenary session. He later sat down with CURE for an interview to expand on these themes.

CURE: What challenges do patients face in accessing cancer care globally?

Agrawal: Some of the same challenges globally, some of the same themes that we see in the United States from the patient perspective, is the lack of access: getting to treatment, getting to screening and being able to pay. That's the number one: financial toxicity, same as in the United States. Globally, there is a lack of insurance.

Oftentimes, families are spending all their valuables to be able to pay for treatment. For education, that's a really common problem where patients and families don't understand the treatment or the diagnosis and what their options are. Lack of palliative care is a real big problem, so there are a lack of pain medications and no survivorship care at all; once patients finish treatment, there's really nothing after that.

Stigma is also a big problem globally, where people can't talk about their diagnosis and their treatment, and they may be stigmatized within their families or their communities.

How can health systems adapt to meet growing cancer burdens?

Another big, big, big topic and big challenge. Number one is awareness. We've reached that point now where countries have started to include cancer in their national cancer control plans, and then the next big step is implementation. So, that's a big challenge.

Now, resources are very tight in a lot of these settings, and so how do countries prioritize cancer over other topics? Because the burden is increasing and the impact on the economy is increasing, that is hopefully going to make it more of a priority for countries to bring resources in. I think the opportunity is to think about where you can be most cost-effective in the way you provide care.

Many of the drugs that are needed, especially if you can screen patients and get them to treatment when they're at an earlier stage, are not that expensive. So, I think it's a lot about how you prioritize care appropriately.

What role does education play in improving outcomes for patients?

We know that in the United States, patients and their caregivers are advocates. They know about their disease, they know about their treatment options, they ask about clinical trials and they ask about what else they could have, like supportive care and second opinions. Similarly, in the global setting, we find it's very important to educate patients and caregivers, but also providers. In a lot of these settings, it's very hierarchical.

Providers don't talk to patients and caregivers in a way that they understand the diagnosis and the treatment. Also, if the disease recurs, what are their options? Talk to them about palliation at an early stage. We try to equip both patients and caregivers, but also providers, with trainings so they learn how to provide the information correctly, and so that patients and caregivers, from their side, know how to ask for it.

Another important resource that we work on developing is patient navigation. Similar to the United States, patient navigators can be a conduit of information for patients and caregivers and be their advocate. They can speak to them on their own level, talk to the providers and make sure that they're understanding and know what their options are.

How are technologies globally improving access to care?

Technology is a really great opportunity to improve access. We're still in the early stages, but technology can decrease inequities. It can also increase inequities. We must be very careful about how we utilize it. Right now, we're really thinking about how best to utilize it. I don't think it's been fully utilized yet, but examples are being able to have an electronic health record, which really is nonexistent in a lot of countries but is being developed. That'll be a way for patients to get better care and to be monitored, potentially being able to use other technologies where they can be remotely monitored, especially in settings where there aren't a lot of resources.

To be able to use AI and other technologies to help with imaging readings and symptom monitoring, we're still at a very early stage. But I think in settings where there are very limited providers, it will provide an opportunity to improve care. We have to be thoughtful about how we implement it together so that it improves care and doesn't increase inequities.

What policy changes are needed to support equitable care?

Most countries now, if you look at their national cancer control plans, include language about patient engagement, patient-centered care and involving persons with lived experience in how cancer care is delivered. But what's lacking is really implementing that — moving to the next step from policy to actual implementation and action.

We, as an advocacy organization, and other advocacy organizations must really work together to push that next step to getting to the implementation side. We see patient navigation as a key tool to be able to break down barriers and improve access at an individualized level. It's a resource that's evidence-based. It's also not a very expensive resource in these settings when resources are limited.

We see that as a clear example of where you have a tool that can help with implementation. There are others as well, like technology, but I think we still must really work together to get to that place where implementation happens for more equitable access.

Transcript has been edited for clarity and conciseness.

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