Re-envisioning the value proposition for investment in cancer care

The place of cancer within broader health system development highlights key contradictions and distortions. Although innovation in cancer care, spanning medicines, artificial intelligence, and radiation therapy, are advancing rapidly, these technologies can be costly and often provide marginal benefits. Lower-cost approaches, such as screening, patient navigation, and supportive care, remain underutilized, especially in developing health systems. Simultaneously, the financial burden of cancer exacerbates inequities, driving patients into poverty and straining under-resourced systems. To address these contradictions, we call for a re-envisioning of cancer care as a strategic investment within health systems by presenting 4 key transitions: (1) a shift in the predominant narrative of cancer control as a clinical problem to positioning it as a universal health system priority, with far-reaching societal and economic benefits; (2) a greater emphasis on how cancer care supports health system strengthening across the full continuum of services involved in cancer control; (3) a view on cancer treatment as a gateway for technology and systemic investments, showcasing the potential to generate and use cross-cutting improvements with benefits across clinical areas; and (4) the need to align cancer control with rigorous fiscal, economic, and operational planning to ensure that investments deliver broad and sustainable health system impacts. By embedding cancer control into health system development, governments can optimize resources, strengthen system resilience and close equity gaps while addressing current and future health challenges.