[Access to cancer treatment: financial difficulties, system sustainability, methodological rigor. The role of scientific journals.]

The growing national economic burden linked to cancer spending is certainly impacted by an aging population, yet it finds its greatest obstacle in the ever-increasing costs for diagnostics, therapies, and hospital care, putting a strain on patients' finances of the family and the health system. Even in a universal healthcare system like the Italian one, where much of the difficult decisions on healthcare spending are in the hands of government technicians, and shaped by political will, patients contribute to cancer costs out of their own pockets to a much greater extent than is perceived from common sense. The sustainability of the cancer care system cannot ignore the meticulous control of public spending, which is fundamental and essential for societies that aim to keep the standards of care extremely high and continuously improve access and reduce inequalities in cancer care. Clinical trials, healthcare professionals and patients are best placed to evaluate the costs and benefits of treatment choices and are among the most financially affected by such decisions. Can scientific journals in the sector have their contribution for improvement? How can journals potentially close this gap and inform doctors, taxpayers, and the general population? To address this problem effectively, attention needs to be paid to two fundamental issues: one is high-quality science, and another is the ability to inform decision-making.