Global oncological surgery at a crossroads: Overcoming inequities and disparities through collective action and strategic vision.

Surgical oncology is essential for the management of most solid tumours, yet access to safe, timely, and appropriate cancer surgery remains severely limited in low- and middle-income countries (LMICs), as well as among vulnerable populations globally. This position paper presents a shared assessment of inequity in surgical oncology and a framework for addressing it across epidemiological, socioeconomic, and structural factors. Major barriers identified include critical workforce shortages, inadequate pathology and radiotherapy infrastructure, financial toxicity, geographic disparities in service concentration, fragmented national cancer control policies, and the persistent absence of multidisciplinary tumour board structures in most LMICs. Proposed solutions include the expansion of patient navigation programmes, telemedicine and virtual tumour boards, structured workforce development through international fellowships and bidirectional educational exchange, population-based cancer registries for rational capacity planning, and North-South research partnerships. Failure to act is projected to result in cumulative global GDP losses of US$6.2 trillion by 2030. New international initiatives like the World Society of Surgical Oncology (founded 6 November 2025) may advance collaboration through capacity building, advocacy, and evidence generation.