Peer-Reviewed Publication
Lancet Oncol2026September 25, 2026Journal Article
Accelerating equitable cancer genomics and precision oncology in health care and research: a Lancet Oncology Commission.
Raffaella Casolino1, Joaquin Mateo2, Elisabeth G E de Vries3, Amber Johns4, Melanie Courtot5, Rita T Lawlor6, Sandra Perdomo7, Stacy W Gray8, Raquel Perez-Lopez9, Clare Turnbull10, David Torrents11, Kerstin Noelle Vokinger12, Dilara Akhoundova13, Jean-Marc Bourque14, Andrés F Cardona15, Yoon Jung Chang16, Debyani Chakravarty17, Ievgeniia Chicherova18, Karen Ann Cranston19, Melissa Davis20, Amanda Drury21, Oskar Frisell22, Raquel Manzano Garcia23, Robert L Grossman24, Yosr Hamdi25, Simon Hediger12, Thomas Hofmarcher26, Oliver Hofmann27, Jakob Nikolas Kather28, Hannah Kim29, Kazuto Kato30, Bartha Maria Knoppers31, Kjong-Van Lehmann32, Dilani Lokuhetty33, Patricia M LoRusso34, Deborah Mascalzoni35, Nicola Mulder36, Travis Osterman37, Folakemi Odedina38, Aparna R Parikh39, Solomon Rotimi40, Brian Rous41, Shawn Sweeney42, Bhawna Sirohi43, Zbyslaw Sondka44, Ciara Staunton45, Kjetil Taskén46, Alex Wagner47, C Benedikt Westphalen48, Jianmin Wu49, Joly Yann31, Ma'n H Zawati31, Andrew V Biankin4, Takayuki Yoshino50, Lincoln Stein51, Mark Lawler52
1International Cancer Genome Consortium, University of Glasgow, Glasgow, UK. Electronic address: raffaella.casolino@glasgow.ac.uk.
2Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
3Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
4International Cancer Genome Consortium, University of Glasgow, Glasgow, UK.
5Ontario Institute for Cancer Research, Toronto, ON, Canada; Medical Biophysics Department, University of Toronto, Toronto, ON, Canada; Department of Computer Science, University of Toronto, Toronto, ON, Canada.
6ARC-Net Cancer Research Centre and Department of Engineering for Innovative Medicine, Verona, Italy.
7Genomic Epidemiology Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France.
8System Strategy and Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA.
9Radiomics Group, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
10Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.
11Life Sciences Department, Barcelona Supercomputing Center, Barcelona, Spain; ICREA, Barcelona, Spain.
12Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Faculty of Law, University of Zurich, Zurich, Switzerland.
13Department of Medical Oncology, University Hospital of Bern, University of Bern, Bern, Switzerland.
14Department of Radiation Oncology, CHUM, Montreal, QC, Canada; CRCHUM, Montreal, QC, Canada; ESPUM, Montreal, QC, Canada.
15Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center, Bogotá, Colombia.
16National Cancer Center, Goyang, South Korea.
17Memorial Sloan Kettering Cancer Center, New York, NY, USA.
18International Agency for Research on Cancer, Lyon, France.
19Techna Institute, University Health Network, Toronto, ON, Canada.
20Morehouse School of Medicine, Atlanta, GA, USA.
21Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland.
22Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Solna, Sweden; IHE Swedish Institute for Health Economics, Lund, Sweden.
23Cancer Research UK Cambridge Institute, Cambridge, UK.
24Department of Medicine and Computer Science, University of Chicago, Chicago, IL, USA.
25Research Department at the National Laboratory of Human Genomics and at the Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia.
26IHE Swedish Institute for Health Economics, Lund, Sweden.
27Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.
28Else Kroener Fresenius Center for Digital Health and Department of Medicine I, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany; Pathology & Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
29College of Medicine, Asian Institute for Bioethics and Health Law (AIBHL), Yonsei University, Seoul, South Korea.
30Graduate School of Medicine and Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), University of Osaka, Suita, Japan.
31Faculty of Medicine and Health Sciences, Department of Human Genetics, McGill University, Montreal, QC, Canada.
32RWTH Aachen University and University Hospital Aachen, Aachen, Germany.
33International Agency for Research on Cancer, Lyon, France; Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
34Yale Cancer Center, Yale University, New Haven, CT, USA.
35Institute for Biomedicine, Eurac Research, Bolzano, Italy; Department of Public Health and Caring Sciences, Centre for Research Ethics & Bioethics (CRB), Uppsala University, Uppsala, Sweden.
36Computational Biology Division, IDM, South African Medical Research Council (SAMRC) UCT AI for African Population Health Research Unit, University of Cape Town, Cape Town, South Africa.
37Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
38Mayo Clinic, Jacksonville, FL, USA.
39Mass General Brigham Cancer Institute, Boston, MA, USA.
40Department of Biochemistry and Cancer Genomics Laboratory, Covenant University, Ota, Nigeria.
41Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
42AACR Project GENIE Coordinating Center, American Association for Cancer Research (AACR), Philadelphia, PA, USA.
43Vedanta Medical Research Foundation-Balco Medical Center, Raipur, India.
44Catalogue Of Somatic Mutations In Cancer (COSMIC), Wellcome Sanger Institute, Cambridge, UK.
45Royal College of Surgeons in Ireland, Dublin, Ireland.
46Institute of Cancer Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
47Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital and Ohio State University, Columbus, OH, USA.
48Comprehensive Cancer Center LMU and Department of Medicine III, University Hospital, LMU Medizin Ludwig-Maximilians-Universität München, German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
49Peking University Cancer Hospital & Institute, Center for Cancer Bioinformatics, Beijing, China; Peking University International Cancer Institute, Beijing, China.
50Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
51Ontario Institute for Cancer Research, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Vector Institute for Artificial Intelligence, Toronto, ON, Canada.
52Johnston Cancer Research Centre, Queen's University Belfast, Belfast, UK.
Abstract
Cancer genomics and precision oncology are increasingly central to cancer care, but many health systems struggle to implement them equitably, effectively, and sustainably. This Commission defines the current global precision oncology landscape and analyses the scientific, structural, and health-system challenges shaping its delivery and impact. Findings indicate that access to cancer genomics and…
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