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The global cancer burden is rising dramatically, with ~20 million new cases and nearly 10 million deaths in 2022. Yet access to quality oncology services remains deeply inequitable; only ~39% of countries finance basic cancer care in national health packages. Efficient cancer hospital management demands integrated clinical workflows, strong administrative systems, and sustainable financing. This review summarizes evidence from >20 recent sources on strategies for improving oncology service delivery. We examine clinical operations (care pathways, scheduling, multidisciplinary teams), administrative systems (workforce planning, infrastructure, digital tools), and financial models (cost-effectiveness, PPPs, insurance).