title: Regional variation in identified cancer care needs of early-career oncologists in China, India, and Pakistan.
abstract: BACKGROUND
  Cancer incidence and mortality is increasing in the developing world. Inequities between low-, middle-, and high-income countries affect disease burden and the infrastructure needs in response to cancer. We surveyed early-career oncologists attending workshops in clinical research in three countries with emerging economies about their perception of the evolving cancer burden.
  
  
  METHODS
  A cross-sectional survey questionnaire was distributed at clinical trial concept development workshops held in Beijing, Lahore, Karachi, and Mumbai at major hospitals to acquire information regarding home-country health conditions and needs.
  
  
  RESULTS
  A total of 100 respondents participated in the workshops held at major hospitals in the region (India = 29, China = 25, Pakistan = 42, and other = 4). Expected consensus on many issues (e.g., emergence of cancer as a significant health issue) was balanced with significant variation in priorities, opportunities, and challenges. Chinese respondents prioritized improvements in cancer-specific care and palliative care, Indian respondents favored improved cancer detection and advancing research in cancer care, and Pakistani respondents prioritized awareness of cancer and improvements in disease detection and cancer care research. For all, the most frequently cited opportunity was help in improving professional cancer education and training.
  
  
  CONCLUSIONS
  Predominantly early-career oncologists attending clinical research workshops (in China, India, and Pakistan) identified needs for increasing clinical cancer research, professional education, and public awareness of cancer. Decision makers supporting efforts to reduce the burden of cancer worldwide will need to factor the specific needs and aspirations of health care providers in their country in prioritizing health policies and budgets.
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA lyerl001@mc.duke.edu.
authors.forename: H Kim
authors.initials: HK
authors.lastname: Lyerly
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Fawzy
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Zeba
authors.initials: Z
authors.lastname: Aziz
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Nair
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Pramesh
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Vani
authors.initials: V
authors.lastname: Parmar
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Purvish M
authors.initials: PM
authors.lastname: Parikh
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Rozmin
authors.initials: R
authors.lastname: Jamal
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Azizunissa
authors.initials: A
authors.lastname: Irumnaz
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Ren
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Stockler
authors.affiliation: Duke Cancer Institute, Department of Surgery, Department of Pathology, and Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA; Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan; Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India; Clinical Trials Unit, Aga Khan University, Karachi, Pakistan; Capital Medical University Cancer Center, Beijing, People's Republic of China; National Health and Medical Research Council Clinical Trials Centre, Royal Prince Alfred and Concord Hospitals, University of Sydney, Sydney, New South Wales, Australia; Department of Precision Oncology, Asian Institute of Oncology, Sion, Mumbai, India; Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Department of Medical Oncology, Tata Medical Center, Kolkata, India; Research Triangle Institute, Research Triangle Park, North Carolina, USA; Flatiron Health, New York, New York, USA.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D003906:Developing Countries; D006282:Health Personnel; D006291:Health Policy; D006761:Hospitals; D006801:Humans; D007194:India; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D010154:Pakistan; D010166:Palliative Care
keywords: Barriers; Cancer care; Developing nations; Global health; Healthcare infrastructure; Professional education