Global disparities in access to diagnostics and therapies for advanced non-small cell lung cancer: from discovery to delivery – a review

Advanced non-small cell lung cancer (NSCLC) has undergone a profound transformation over the past two decades through the integration of molecular diagnostics, targeted therapies, and immunotherapy into clinical practice. Despite these advances, access to modern diagnostics and treatments remains highly uneven across regions and health-care systems, leading to persistent global disparities in diagnostic accuracy, therapeutic options, and patient outcomes. This review explores diagnostic and therapeutic disparities in advanced NSCLC across high-, middle-, and low-income settings, a disease context that is increasingly dependent on timely access to molecularly guided treatment decisions. We describe regional and income-related differences in the availability and implementation of molecular diagnostics and novel systemic therapies, and discuss structural and systemic factors influencing access to innovation, including health-care infrastructure, regulatory environments, and resource constraints. By synthesizing evidence from international guidelines, real-world studies, and global oncology literature, this narrative review highlights how unequal adoption of advances in NSCLC care continues to contribute to outcome differences worldwide and identifies key challenges relevant to future efforts aimed at reducing inequities.