Inequalities in Surgical Oncology: Access, Experience, Recovery and Outcomes

Surgical oncology is a cornerstone of curative cancer care. The last two-decades have seen major advances in surgical techniques through technological transformation, along with progressive models of perioperative care. Together with data-driven risk stratification, and the availability of screening and detection programs, these innovations contribute to better patient experience and long-term outcomes. In spite of such developments and their ongoing sophistication, stubborn inequalities persist across the care continuum in access to timely, appropriate, and high-quality surgical treatment and rehabilitation. Inequalities are driven by a multitude of cumulative, intersecting disadvantages including socioeconomic status, geography, race, disability, gender, and healthcare system factors. Emerging trends, such as the rising incidence of early-onset cancers—including colorectal, pancreatic, and lung cancer—have further exposed the depth of structural gaps in screening, diagnostic pathways, and research inclusion for younger patients. At the opposite end of the age spectrum, older and very elderly adults frequently experience age-based exclusion from screening programs, surgical interventions, and clinical trials, despite wide variability in biological fitness and life expectancy. These inequalities shape stage at diagnosis, treatment selection, quality of life, and outcomes. During a period of rapid innovation, it is imperative that progress in patient care pathways better translates into equitable benefit across all populations.This Research Topic aims to advance understanding of inequalities across the full surgical oncology pathway—from referral and diagnosis through treatment selection, perioperative management, patient experience and long-term outcomes. We welcome contributions that move beyond describing patterns of inequalities alone to submissions that interrogate intersectional mechanisms shaping unfair difference in access, experience and outcomes, with a strong emphasis on opportunities for change at patient, provider, and health system level. Recent advances in patient-reported outcomes, population-level and real-world datasets, and implementation science provide new opportunities to detect inequalities earlier and to evaluate equity-focused interventions in everyday practice. We particularly welcome work that addresses systemic under-representation of populations often least served by screening programs, clinical decision-making, and research. For example, younger patients with early-onset cancers, older or very elderly adults, individuals in low-income settings, and those of diverse racial and cultural backgrounds. By integrating a health-inequalities lens into surgical outcomes research and insights from psychosocial and supportive care, this collection seeks to drive the adoption of practical, scalable strategies that improve equity across the multiple pathway points where disadvantage manifests.We welcome interdisciplinary submissions across tumour sites and care settings that address inequalities in surgical oncology using quantitative, qualitative, and mixed methods approaches, including implementation studies and service evaluations. We invite original research, systematic or scoping reviews, and perspective articles including from patient and public contributors. Submissions should interrogate social, structural, and organizational determinants that shape access, clinical decision making, rehabilitation and long-term outcomes. Indicative topics include:• Disparities in referral pathways, screening eligibility, diagnostic intervals, time-to-surgery, and access to high-volume or specialist centre• Inequities in treatment selection and access to guideline-recommended or advanced surgical procedures (e.g., minimally invasive, organ-sparing, complex resections, reconstruction)• Differences in perioperative, oncologic, and patient-reported outcomes, rehabilitation, and return to participation in everyday life• Structural, institutional, and interpersonal drivers of inequity (including communication, bias, trust, and health literacy) and evaluated interventions (e.g., navigation programmes, pathway redesign, quality improvement, psychosocial interventions, health policy initiatives)• Intersectional and life course analyses examining how multiple disadvantages accumulate to shape surgical care and outcomes• Use of health data and digital technology innovation with attention to improving equitable implementation• Innovation in training pathways, leadership and role design that influence fairer outcomes for allPlease note: manuscripts consisting solely of bioinformatics or computational analysis of public databases, without validation in an independent cohort or biological validation in vitro or in vivo, are out of scope for this section and will not be accepted as part of this Research Topic. Topic editors: Shivani Sharma, Francesco Giovinazzo Source: https://www.frontiersin.org/research-topics/77417/inequalities-in-surgical-oncology-access-experience-recovery-and-outcomes