Comparative analysis of national cancer policy among low-income, low-middle-income, and high-middle-income countries.

Abstract

e23045 Background: Despite lower incidence rates, under-resources and lower income countries bear a disproportionately high mortality burden due to cancer. The disparities stem from multiple factors: limited healthcare infrastructure and resources, lack of comprehensive cancer prevention strategies, inadequate screening programs, late-stage diagnosis, restricted access to treatment, insufficient trained workforce, and lower health expenditure. The aim of this analysis is to compare cancer-related policy in under-resourced parts of the world. Methods: The World Health Organization (WHO)’s International Agency for Research on Cancer and Noncommunicable Disease Repository (NCDR) was searched and data extracted on the incidence of national cancer policy or guidelines, timeline when policies were most recently updated and presence of plans pertaining to specific oncological conditions. The NCD Repository included data from 2015-2023. Countries were subdivided into low income (LIC), low-middle income (LMIC) and high-middle income (HMIC) according to the World Bank's 2025 categorizations. Incidence and mortality rates due to cancer in the different World Bank Classifications were derived from the WHO Data Repository. Descriptive statistics were utilized. Results: 131 countries were identified as part of the WHO LIC, LMIC and HMIC categories. Amongst these, 70.2% (N = 92) had national cancer policy or guidelines. 57.7% of LIC's, 76.4% LMIC's and 70.4% HMIC's had cancer-related policy or plan documented in the WHO Repository. There were no significant differences between the incidence of national cancer plans in different income categories. Furthermore, 38.5% LIC's, 27.5% LMIC's and 48.1% HMIC's had one or more cancer-specific plans. The most common cancer-specific plans pertained to cervical and breast cancer, with both lung cancer and colorectal occupying the third most frequently devised plan. Gastric and esophageal cancer was another organ-system where countries has specific plans. Amongst LIC's, The ratio between incidence and mortality were 1.38:1 in LIC's, 1.56:1 in LMIC's and 2.07:1 in HMIC's. There was no correlation between existence of plans and mortality rates. Conclusions: While there are marked differences in cancer related mortality, there were no significant differences in existence of policies between different income groups. Further studies should explore the content of the policies and execution of policies, especially pertaining to screening, early detection and treatment costs.