Strategic Cancer-System Data for Radiation Medicine: Value-Feasibility Gaps in Global Planning and Decision-Making from the SUNRISE Initiative

Background: Reliable cancer-system data are needed for capacity planning, resource allocation and accountability. We assessed which patient- and department-level data elements professionals consider important for cancer-service planning and how feasible they are to collect across diverse settings.Methods: We conducted a cross-sectional online survey of cancer-system professionals and service leaders. Respondents rated the importance and local feasibility of 27 data elements linked to 14 recurring planning questions on parallel 5-point scales. Value-feasibility gaps were calculated as importance minus feasibility and summarised by domain and World Bank income group.Results: Among 82 valid respondents from 75 institutions in 48 countries, importance ratings were consistently high, while feasibility was lower and more variable. All 14 planning questions showed positive mean gaps. The largest concerned outcomes, toxicity, patient-reported outcomes, patient experience and treatment-related economic burden. In the small low-income subgroup, substantial gaps also affected baseline patient and tumour characteristics, diagnosis and treatment counts, and timelines. Equipment and workforce data were more closely aligned.Conclusions: Cancer-system data are widely valued for planning but are not consistently feasible to collect. The findings support a harmonised minimum indicator set with staged implementation adapted to local data maturity and resources.