Histopathology forms the core diagnostic tool for cancer in the majority of pathology laboratories around the world; however, there are acknowledged disparities in access to even these diagnostics in low- and middle-income countries and in specific populations within high-income countries. As recognition of the need for cancer care and treatment continues to grow in countries, especially in the wake of new WHO programs for cervical, breast, and pediatric cancers, policy makers and healthcare funders within these countries are seeking tools and processes that allow for the largest number of patients to be diagnosed at the least cost. As histopathology represents the most cost effective diagnostic by sheer number of tumor types and volume, understanding the costs for histology, as well as the impactful benefits of economies of scale (i.e., larger volumes are less expensive per patient) and scope (i.e., the multiple stains available after basic histology sectioning), is paramount to planning an effective publicly-funded/government laboratory. Understanding the economic structure of a country’s population along with the financial model of a histology laboratory also leads to a market understanding of private laboratories, which can provide services at a profit as well as pro bono more cost effectively than purely public laboratories. We have developed a comprehensive, scalable costing tool of a functioning histology laboratory which accounts for all feasible costs and variations in models of service. We demonstrate that a sample volume of approximately 12,000 cases per year is the starting point of optimal laboratory usage for the simplest set up. Furthermore, the optimal funds required per specimen at the optimal point of 12,000 samples ranges from $25 USD to $75 USD, depending on the base economy of the country, which is inconsistent with GDP expected cost differences. This costing tool, especially when used in collaboration with expert consultants, serves as an important costing tool to guide the reorganization and/or implementation of pathology services for cancer for any patient population.Funding: This activity was not supported by external funders.Declaration of Interest: The authors report no conflicts of interest through employment, grant, orother relationships.