Advancing cancer equity in seven high-income countries: an analysis of policy levers and National Cancer Control Plans

Persistent inequities in cancer outcomes remain a defining challenge for global health systems, including in high-income countries. Despite advances across prevention, early detection, treatment, and survivorship, disparities persist, reflecting entrenched social and structural inequities. While equity is increasingly articulated within national and global cancer agendas, comparative analysis of how equity is conceptualised and operationalised in national cancer control planning remains limited. This Policy Review addresses this gap by synthesising evidence across seven high-income countries comprising the G7 Cancer collaboration-Australia, Canada, France, Germany, Japan, the UK, and the USA-drawing on policy frameworks, National Cancer Control Plans (NCCPs), and semi-structured expert interviews. The Policy Review identifies marked variation in equity definitions and application, with most countries emphasising access to care, fewer addressing outcomes or patient experience, and equity often being framed as secondary to broader health system goals. Terminology is inconsistently applied and action on structural determinants is limited. Barriers to NCCP implementation encompass fragmented accountability, restricted policy mandates, and fiscal or cultural sensitivities. Enablers of effective NCCP implementation include data infrastructure systems, multistakeholder engagement, legislative frameworks, and cross-sector collaboration. Synthesising these findings, we present an evidence-informed Policy Framework for Equity in Cancer Control, to guide equitable cancer policy in high-income settings.