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

Background National Cancer Strategies (NCS), including National Cancer Control Plans (NCCPs) and Non-Communicable Disease Plans (NCDPs), shape priorities for cancer systems. Yet, little is known about whether they address human-centred care, including psychosocial support, equity, financial protection, and palliative care. We aimed to (1) assess the extent to which NCS include human-centred care themes relevant to sociocultural factors, systems of care, medical education, economic protection, mental health, and palliative care, and (2) compare inclusion across lower- and higher-income settings. Methods The International Cancer Control Partnership, an initiative developed under the Union for International Cancer Control (UICC), maintains a database of NCS to facilitate cancer planning and policy development worldwide. Using the 2023 UICC global review questionnaire dataset, this secondary analysis examined 20 questionnaire items across 98 NCCPs and 58 NCDPs from 156 countries. Items were grouped into six themes relevant to human-centred care and analyzed by country income level. Findings Only 12% of NCCPs identified people living with cancer as stakeholders. Most countries included strategies addressing palliative care beyond pain management (84%), and 72% included strategies to support families or caregivers of cancer patients. In contrast, few countries addressed social determinants of health (28%), cancer-related inequities (28%), protection against catastrophic expenditure (14%), or referenced essential medicines for psychological distress (3%). Human-centred care themes were less frequently addressed in lower-income settings compared with higher-income settings (32% vs. 44%). Interpretation Themes of human-centred care are infrequently included in NCS, particularly in lower-income countries. Global attention to these themes is needed to advance more equitable, human-centred cancer care worldwide.