Cancer care underuse, overuse, and inequalities

Scientists from the International Agency for Research on Cancer (IARC) and Imperial College London, United Kingdom, propose a novel perspective to examine inefficiencies of health systems by focusing on the simultaneous underuse of cancer prevention and care by underserved populations and overuse by populations with higher access to health care. The article, published in the Journal of the National Cancer Institute, also includes a critical review of the mechanisms underlying the underuse and overuse of cancer care.

The authors propose that the study of the epidemiological features of cancer, including unwarranted variations in cancer outcomes, can provide critical insights into inefficiencies and inequalities in delivering health-care services. For instance, unwarranted variations in cancer mortality between social groups within the same country point to underuse of essential cancer care.

While many individuals struggle to access essential cancer services, more and more resources are being spent on medical interventions that have minimal impact or that can cause harm. Examples are the documented overdiagnosis and overtreatment of thyroid cancer and prostate cancer. For certain cancer sites, the unwarranted variations in incidence across countries and social groups may be an indication of overdiagnosis.

The article highlights key areas for further research and context-specific application to achieve a better balance of access, appropriateness, and necessity of cancer prevention and care while reducing health disparities.

Vaccarella S, Vineis P
Cancer care underuse, overuse, and inequalities
J Natl Cancer Inst. Published online 8 October 2025;
https://doi.org/10.1093/jnci/djaf290

Read the article