Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis

Abstract

Global cancer surgery is an essential and complex component of oncologic care. This study aims to describe global cancer surgery literature since the 2015 Lancet Commission on Global Surgery and Cancer Surgery and perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A systematic search was performed in PubMed of global cancer surgery articles. Themes were extracted from the included studies based on the following criteria: (1) performed in low- or low-middle-income countries, (2) published during or after 2015, (3) published in peer-reviewed journals, (4) written in the English language, and (5) accessible to the authors. Themes were further grouped into strengths, weaknesses, opportunities, and threats (SWOT analysis). The search strategy identified 154 articles published from 1992 to 2022. Forty-six articles were included in the qualitative synthesis and SWOT analysis. Recurring themes included local epidemiologic studies, local innovations and feasibility studies, prioritizing quality of life outcomes, multidisciplinary team approaches, limited resources, health system gaps, lack of economic analyses, diverse cancer management strategies and priorities, inter-setting collaboration, research expansion, the coronavirus disease 2019 pandemic, and unchecked technological advancements. These strengths, weaknesses, opportunities, and threats were described and related to the themes of research, surgical systems strengthening, economics and financing, and political framing of the 2015 Lancet Commission on Global Cancer Surgery. SWOT analyses of global cancer surgery may be helpful in suggesting future strategies for this expanding field. PLAIN LANGUAGE SUMMARY: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected growth of cancer burden, the present gap in cancer surgery care in low-resource settings with stressed health care and surgical infrastructure risks further exacerbation. We present a strengths, weaknesses, opportunities, and threats analysis of recent global cancer surgery literature pertaining to low-resource settings.

Keywords: SWOT analysis; cancer; global cancer surgery; health policy; low- and low-middle-income countries.

Figure 1.

Included publications by year published. The online literature search yielded 123 articles, of which 46 articles met inclusion criteria for analysis. The majority of included studies were open access (n=34) and published between 2021 and 2022 (n=26).

Figure 2.

SWOT analysis of the current global cancer surgery landscape. A literature review was performed of global cancer surgery studies involving low-resource settings published since the landmark 2015 Lancet Commission on Global Surgery and Global Cancer Surgery. Key findings and themes from the included papers were characterized through a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis.