Value, affordability and universal health coverage in global cancer

Since our leadership of the seminal Lancet Oncology Commission Delivering Affordable Cancer Care in High-Income Settings in 2011 we have developed a substantial global program on research into health system cancer economics, value of technologies (in particular medicines, radiotherapy and surgical devices), health technology assessment, value, prioritisation and consensus building e.g. Choosing Wisely India, and innovative financing for global cancer in some of the world’s most vulnerable populations e.g. refugees. Our work has been instrumental in understanding the macroeconomics of cancer (direct costs, as well as productivity losses due to premature mortality and morbidity) and their relationship to improving outcomes (value). We also work with WHO (Essential Medicines for Cancer Committee) and other organisations (e.g. ESTRO) to study the economic impact of technologies in specific contexts and link to different models of social protection, including in-depth ethnographic studies of affordability and cost of illness.

Cancer and palliative care in conflict

We are world leaders in research in the development and delivery of cancer and palliative care in conflict ecosystems through our work with the R4HC-MENA and R4HSSS. Over the last five years, we having been developing capacity and capability for cancer research germane to conflict-humanitarian settings including novel financing with partners in Turkey, Jordan, Pakistan, Palestine and Lebanon. In addition, formative work has been undertaken to understand the unique system issues for delivering cancer care to refugees. Lastly, we have a number of ongoing clinical intervention studies in conflict settings, for example, integrated palliative outcome scale. We are currently supporting WHO on cancer intelligence for the Ukrainian conflict (see Activity tab).

Conflict & Health Research Group

COVID-19 and Cancer Global Taskforce

The Covid-19 and Cancer Taskforce is a global group of cancer leaders spanning the disciplines of cancer across the care continuum from prevention, early detection, treatment and palliative care, to representatives of cancer centre networks and advocacy groups. The taskforce, led by GOG, has been studying the immediate impacts on cancer patients, services, and healthcare workers in high and low & middle income settings as well as treatment decision making and patient/doctor interactions. We also directly address risks for longer-term impacts on cancer outcomes, inequalities, cancer research capacity and affordability of care by developing new approaches to build resilient cancer services with readiness to respond to pandemics, especially in low- and middle-income countries whose cancer services are especially vulnerable in the face of this unprecedented public health challenge.

COVID-19 and Cancer Global Taskforce

Global cancer research systems

GOG works with partners around the world to support the development of research capacity and capability, an essential part of national cancer control programs and delivering more affordable and better patient outcomes. We have a long-standing partnership with Tata Memorial Centre and the National Cancer Grid of India to support research capacity through the CReDO (International Collaboration for Research methods Development in Oncology) program, as well as capacity-building programs in the Middle East and Sub Saharan Africa, particularly Zambia and Ghana. GOG also has a very active research program using research intelligence tools (scientometrics) to analyse cancer research systems. Our cancer research mapping has been utilised by a wide range of Lancet Oncology and World Bank DCP3 Commissions to inform national and global policy.

The International Collaboration for Research methods Development in Oncology (CReDO)

Innovative technologies for global cancer

GOG has a wide range of clinical studies and programs ongoing including artificial intelligence (AI) based radiotherapy treatment planning and the development of virtual reality surgical simulation for cancer surgery with LMIC partners across the globe. The Group also has significant expertise and ongoing projects in low-cost diagnostic technologies such as Cyto-sponge for Barret’s oesophagus and a range of technologies for cervical screening. This work is underpinned by programs of public policy and health systems analysis to understand the implementation and impact of cancer technologies once they enter cancer systems. GOG particularly works with WHO IARC (International Agency for Research on Cancer) with its technology implementation science programs. GOG has created collaborations with leaders in the field of technology development such as Southern Methodist University and MD Anderson with major partners across over a dozen LMIC countries.

Virtual Reality Surgery Simulator (VRSS)

Global cancer services and systems

GOG studies how different models of health (cancer) system design impact equity in access, travel burden and patient outcomes in collaboration with our partners at LSHTM. We have supported many countries in examining their cancer care systems as part of national cancer control planning. In addition, we have major programs in cancer services and systems especially for urological and bowel cancers , as well as work on cancer surgical systems and new models of service design to deliver radiotherapy. Our current work focuses on how optimising the structure and function of health services improves cancer outcomes in a range of different LMIC settings using patient focused measures. Our work in health (cancer) services and systems is aligned with broader studies around the political economy of cancer care and evolving nature of cross national border cancer care. GOG has supported systems research for both adult and childhood cancers. In the latter, we work closely with major organisations such as SIOP and the World Health Organisation.

Lived experiences and patient perspectives in global cancer

The growing incidence of cancer that low- and middle-income countries face is raising social, cultural, political, ethical, and economic challenges of global cancer that require research beyond the traditional biomedical-clinical nexus. GOG pursues social science studies led by Dr Carlo Caduff [https://www.kcl.ac.uk/people/carlo-caduff] committed to qualitative research methods that foreground the narratives and perspectives of a wide range of stakeholders (i.e. patients, family members, medical practitioners at all levels and from many systems of medicine). Our aim is to give voice to the lived experiences, motivations and constraints of all who are touched by cancer and involved in cancer care. This approach humanizes and adds richness to our understanding of cancer in heterogeneous and complex settings across the world. As part of this work stream, we have also contributed to building social science research capacity in the global south.