Oncology in the US excels at treatment innovation but struggles to ensure accessibility to said treatment. This editorial takes a wide-angle look at the US cancer care system and its decidedly mixed success: extraordinary scientific successes and generally favorable age-standardized cancer mortality…at costs that far outpace other high-income nations with substantial administrative overhead. While there is no lack of medical ingenuity, it has largely failed to be translated into high-value, equitable care. Potential solutions include greater transparency around treatment costs and value, stronger evidence standards for high-cost drugs, improved price negotiation and drug competition, reduced administrative waste, better integration of palliative care, and novel strategies to address rural and underserved populations. | Raghavan, JCO Oncol Pract 2026
