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The integration of molecular, genomic and epigenetic biomarkers into oncological diagnostics represents a paradigm shift in precision medicine, fundamentally transforming tumour classification and management. However, global adoption of molecular biomarkers remains profoundly asymmetric. Populations in low- and middle-income countries (LMICs) experience substantial deficits in access to even foundational diagnostic services. Given that LMICs are projected to account for nearly 80% of the estimated 21.6 million annual cancer cases by 2030, the imperative for the WHO to ensure its tumour classification systems promote health equity rather than inadvertently perpetuate existing disparities has never been more urgent.1