Barriers to advancing global oncology in an NCI-Designated Cancer Center: A cross-sectional survey of faculty perspectives.

54 Background: Global oncology seeks to improve the delivery of equitable cancer care across diverse populations, including those in low- and middle-income settings. Recognizing the importance of global engagement in addressing cancer disparities, the National Cancer Institute (NCI) has designated global oncology as a strategic priority for its cancer centers. However, many academic institutions still face challenges in integrating global oncology into their care, research, and education missions. We conducted an institutional needs assessment to identify barriers to engagement in global oncology among oncology faculty at the NCI-designated University of Colorado Cancer Center. Methods: A cross-sectional survey was conducted from February 2 to March 20, 2025, using an instrument adapted from the NCI Global Oncology Assessment Survey. The anonymous survey was distributed to University of Colorado Cancer Center members via email, with 5 weekly reminders. It assessed familiarity with global oncology, current or prior involvement in global projects, motivations for participation, and perceived barriers. Results: Twenty-two faculty completed the survey. Over one-third (36%) reported unfamiliarity with the concept of global oncology, and only 45% had prior involvement in related initiatives. Just 14% had worked directly with the institution’s global oncology team. Among all respondents, primary motivations to engage in global work included personal interest (77%), opportunities for collaboration (50%), and a commitment to addressing health disparities. Among those with prior experience, 80% cited challenges securing adequate or sustained funding, 60% reported limited institutional support, 50% noted administrative burdens, and 50% expressed concerns about lack of academic recognition for global work. When asked more broadly about what had prevented or limited their participation, respondents most frequently mentioned limited funding (36%), lack of time (27%), and lack of institutional support (22%). Some respondents acknowledged that their reported familiarity and involvement may be overestimated due to response bias. Conclusions: Despite strong personal interest and alignment with NCI priorities, global oncology remains under-recognized and under-supported within academic centers. Structural barriers—particularly limited funding mechanisms, insufficient institutional backing, and administrative complexity—impede broader faculty engagement. Addressing these challenges through targeted support, dedicated funding, and academic recognition can enhance institutional capacity to deliver equitable cancer care locally and globally.