You have full access to this article via your institution. When a 65-year-old woman in Port Harcourt, Nigeria, arrives at a clinic, she finally learns that she has late-stage lung cancer. For months, her symptoms of breathlessness and exhaustion had been misdiagnosed. She has never smoked cigarettes, but she cooks over a charcoal stove daily, as have generations of women in her family. Her story is not unusual. Whether in Accra, Kingston or New York City, people of African descent who have lung cancer are more likely to be diagnosed late, less likely to receive appropriate care and more likely than white people to die from the disease 1 . Yet these patterns are rarely acknowledged as a global phenomenon. Instead, they are treated as separate regional issues. African American, African and Afro-Caribbean people are considered distinct groups. This fragmentation obscures the truth: the same societal factors shape lung cancer outcomes across continents 2 .…