Aims
To examine equity-related policies and experiences across G7 Cancer member countries and identify levers to advance equitable cancer outcomes.
Methods
A qualitative, multi-phase policy analysis was conducted across seven high‑income countries between March and November 2025. The study comprised: (1) a review of 53 national and international cancer and health equity frameworks; (2) analysis of ten National Cancer Control Plans (NCCPs), examining equity definitions, goals, indicators, and accountability mechanisms; and (3) semi‑structured interviews with 20 policy, research, and civil‑society experts (74% response rate) purposively sampled to represent all seven countries, exploring equity perspectives, implementation experiences, and enabling factors. Data were analysed using thematic analysis within a constructivist–interpretivist paradigm.
Results
Equity was widely referenced but rarely defined. Only 34% of frameworks and 30% of NCCPs provided an explicit definition, and terminology was applied inconsistently, including tension between equity and equality. Equity was predominantly framed as access to services rather than quality of care, patient experience, or outcomes.
Most (90%) NCCPs included an equity statement and all included objectives to reduce cancer disparities. Despite strong normative commitments, none specified measurable equity indicators or targets, highlighting a gap between commitment and operationalisation.
Equity enablers included national leadership, sustained political commitment, participatory governance incorporating lived experience, dedicated financing, and cross‑sector collaboration. Implementation barriers included fragmented accountability, limited data infrastructure, and constrained mandates to address structural determinants of health. Findings informed development of a Policy Framework for Equity in Cancer Control.
Conclusions
The Policy Framework aligns with the emphasis on equity in NCCPs, including the Australian Cancer Plan, offering a practical tool to support translation of equity commitments into measurable action across all levels of service delivery. Findings underscore the importance of health systems, service providers, and researchers aligning governance, data systems, and accountability mechanisms to ensure cancer system performance gains are equitably realised.