Cancer research from the bench, to the bedside and beyond continues to make major strides leading to decreased mortality, an increased number of survivors and improved quality of life. What is less apparent is how well these research findings are translated into high quality equitable, evidence-based care and an effective, acceptable mechanism for monitoring care. Australian cancer health professionals are among the world’s best; helping to save lives, promote good health, prevent disease and improve quality of life. Whilst this suggests that evidence-based health care and quality management have been generally adopted there are noticeable areas of concern, especially around access to and continuity of care. For over two decades, the influence of the social determinants of health has been known, not just on health status and survival, but also on treatment patterns. Health systems that pride themselves on universality should be concerned if people are being effectively discriminated against due to location, socio-economic, financial or racial factors. From a research, policy and practice perspective, it is not enough to know what works for the average patient with the average specialist, but who receives what treatment, where, when and why and, importantly, why not.