{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T17:10:13Z","timestamp":1788801013959,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"DOI":"10.1186\/s12913-026-15519-6","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:53:49Z","timestamp":1788605629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer care in Pakistan: a national survey of infrastructure, diagnostic capacity, therapeutic access, and workforce perspectives"],"prefix":"10.1186","volume":"26","author":[{"given":"Asim Jamal","family":"Shaikh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Shaukat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Sarwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Salam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif Ur","family":"Rab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Nadeem","family":"Abbasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Faheem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeem","family":"Parvez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikram A.","family":"Burney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"15519_CR1","volume-title":"Seventh Population and Housing Census 2023","author":"Pakistan Bureau of Statistics","year":"2023","unstructured":"Pakistan Bureau of Statistics. Seventh Population and Housing Census 2023. Islamabad: Government of Pakistan; 2023."},{"key":"15519_CR2","unstructured":"The Commonwealth fund. international health care system profiles: Pakistan. New York: the commonwealth fund. 2025. Available from: https:\/\/www.commonwealthfund.org\/international-health-policy-center\/countries\/pakistan."},{"issue":"3","key":"15519_CR3","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229\u201363.","journal-title":"CA Cancer J Clin"},{"key":"15519_CR4","unstructured":"International agency for research on cancer. Pakistan \u2014 Global cancer observatory (GLOBOCAN 2022) fact sheet. Lyon: IARC\/WHO. 2024. Available from: https:\/\/gco.iarc.who.int."},{"key":"15519_CR5","doi-asserted-by":"crossref","unstructured":"Mushtaq N, Mustansir F, Minhas K, Usman S, Qureshi BM, Bouffet E, et al. Building the ecosystem for pediatric neuro-oncology care in Pakistan: results of a 7-year twinning programme between Canada and Pakistan. Pediatr Blood Cancer. 2022.","DOI":"10.1002\/pbc.29726"},{"key":"15519_CR6","doi-asserted-by":"crossref","unstructured":"Virani SS, Ahmed KS, Springer M, Hussain M, Christensen L, Asif F, et al. Cancer registries in Pakistan: a scoping review. Lancet Reg Health Southeast Asia. 2025;38.","DOI":"10.1016\/j.lansea.2025.100615"},{"key":"15519_CR7","unstructured":"Pakistan atomic energy commission. Cancer hospitals (Medical Directorate). Islamabad: PAEC. Available from: https:\/\/paec.gov.pk\/Medical\/."},{"issue":"9","key":"15519_CR8","first-page":"e44641","volume":"15","author":"SJ Khan","year":"2023","unstructured":"Khan SJ, Asif M, Aslam S, Khan WJ, Hamza SA. Pakistan\u2019s healthcare system: a review of major challenges and the first comprehensive universal health coverage initiative. Cureus. 2023;15(9):e44641.","journal-title":"Cureus"},{"key":"15519_CR9","volume-title":"Health system performance assessment: a framework for policy analysis","year":"2022","unstructured":"Papanicolas I, Rajan D, Karanikolos M, Soucat A, Figueras J, editors. Health system performance assessment: a framework for policy analysis. Copenhagen: European Observatory on Health Systems and Policies; 2022."},{"key":"15519_CR10","doi-asserted-by":"publisher","first-page":"607","DOI":"10.2147\/RMHP.S366759","volume":"16","author":"PB Kodali","year":"2023","unstructured":"Kodali PB. Achieving universal health coverage in low- and middle-income countries: challenges for policy post-pandemic and beyond. Risk Manag Healthc Policy. 2023;16:607\u201321.","journal-title":"Risk Manag Healthc Policy"},{"issue":"9","key":"15519_CR11","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.1245\/s10434-017-5833-3","volume":"24","author":"YL Basta","year":"2017","unstructured":"Basta YL, Bolle S, Fockens P, Tytgat KMAJ. The value of multidisciplinary team meetings for patients with gastrointestinal malignancies: a systematic review. Ann Surg Oncol. 2017;24(9):2669\u201378.","journal-title":"Ann Surg Oncol"},{"issue":"12","key":"15519_CR12","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/j.clon.2016.07.003","volume":"28","author":"AN Abbasi","year":"2016","unstructured":"Abbasi AN, Karim MU, Ali N, Hafiz A, Qureshi BM. Multidisciplinary team tumour boards are a lifeline for our cancer patients in lower- and middle-income countries. Clin Oncol. 2016;28(12):799.","journal-title":"Clin Oncol"},{"key":"15519_CR13","doi-asserted-by":"publisher","unstructured":"Blackwood B et al. The value and future developments of multidisciplinary team cancer care. Am Soc Clin Oncol Educ Book. 2019. Available from: https:\/\/doi.org\/10.1200\/EDBK_236857.","DOI":"10.1200\/EDBK_236857"},{"issue":"29","key":"15519_CR14","doi-asserted-by":"publisher","first-page":"3439","DOI":"10.1200\/JCO.20.00642","volume":"38","author":"MI Patel","year":"2020","unstructured":"Patel MI, Lopez AM, Blackstock W, Reeder-Hayes K, Moushey EA, Phillips J, et al. Cancer disparities and health equity: a policy statement from the American Society of Clinical Oncology. J Clin Oncol. 2020;38(29):3439\u201348.","journal-title":"J Clin Oncol"},{"issue":"6","key":"15519_CR15","doi-asserted-by":"publisher","first-page":"e223","DOI":"10.1016\/S1470-2045(14)70117-2","volume":"15","author":"CS Pramesh","year":"2014","unstructured":"Pramesh CS, Badwe RA, Borthakur BB, Chandra M, Raj EH, Kannan T, et al. Delivery of affordable and equitable cancer care in India. Lancet Oncol. 2014;15(6):e223\u2013233.","journal-title":"Lancet Oncol"},{"key":"15519_CR16","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s12939-025-02421-6","volume":"24","author":"AR Sarker","year":"2025","unstructured":"Sarker AR, Islam R, Tran-Duy A. Out-of-pocket cost and financial catastrophe of patients with cancer: the alarming cost-of-illness in Bangladesh. Int J Equity Health. 2025;24:186.","journal-title":"Int J Equity Health"},{"key":"15519_CR17","doi-asserted-by":"publisher","first-page":"e2100132","DOI":"10.1200\/GO.21.00132","volume":"8","author":"Z Aziz","year":"2022","unstructured":"Aziz Z, Naseer H, Altaf A. Challenges in access to new therapeutic agents: marginalized patients with cancer in Pakistan and the need for new guidelines. JCO Glob Oncol. 2022;8:e2100132.","journal-title":"JCO Glob Oncol"},{"key":"15519_CR18","doi-asserted-by":"crossref","unstructured":"Wisniewska K, Marku E, Ugurbas MV, Hartmane I, Shukurova M. Innovations in cancer diagnosis and treatment: prospects and challenges. Healthc Low-Resour Settings. 2024.","DOI":"10.4081\/hls.2024.12831"},{"issue":"10","key":"15519_CR19","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1634\/theoncologist.2019-0261","volume":"24","author":"SJ Nass","year":"2019","unstructured":"Nass SJ, Cohen MB, Nayar R, Zutter MM, Balogh EP, Schilsky RL, et al. Improving cancer diagnosis and care: patient access to high-quality oncologic pathology. Oncologist. 2019;24(10):1287\u201390.","journal-title":"Oncologist"},{"key":"15519_CR20","volume-title":"Cancer control: knowledge into action. Module 4: diagnosis and treatment","author":"World Health Organization","year":"2008","unstructured":"World Health Organization. Cancer control: knowledge into action. Module 4: diagnosis and treatment. Geneva: WHO; 2008."},{"key":"15519_CR21","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12904-025-01800-8","volume":"24","author":"M Wang","year":"2025","unstructured":"Wang M, Ding X. Integrated palliative care improves the quality of life of advanced cancer patients. BMC Palliat Care. 2025;24:162.","journal-title":"BMC Palliat Care"},{"issue":"1","key":"15519_CR22","doi-asserted-by":"publisher","first-page":"e012332","DOI":"10.1136\/bmjopen-2016-012332","volume":"7","author":"SRP Franzen","year":"2017","unstructured":"Franzen SRP, Chandler C, Lang T. Health research capacity development in low- and middle-income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature. BMJ Open. 2017;7(1):e012332.","journal-title":"BMJ Open"},{"issue":"1","key":"15519_CR23","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1071\/PY10081","volume":"18","author":"L Holden","year":"2012","unstructured":"Holden L, Pager S, Golenko X, Ware RS. Validation of the research capacity and culture (RCC) tool: measuring RCC at individual, team and organisation levels. Aust J Prim Health. 2012;18(1):62\u20137.","journal-title":"Aust J Prim Health"},{"key":"15519_CR24","doi-asserted-by":"crossref","unstructured":"Gunja MZ, Gumas ED, Williams RD, Doty MM, Shah A, Fields K. The cost of not getting care: income disparities in the affordability of health services across high-income countries. Eur J Public Health. 2024;34(3).","DOI":"10.1093\/eurpub\/ckae144.014"},{"key":"15519_CR25","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1186\/s12913-022-08927-x","volume":"22","author":"A Afaya","year":"2022","unstructured":"Afaya A, Ramazanu S, Bolarinwa OA, Yakong VN, Afaya RA, Aboagye RG, et al. Health system barriers influencing timely breast cancer diagnosis and treatment among women in low- and middle-income Asian countries: a mixed-methods systematic review. BMC Health Serv Res. 2022;22:1601.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"15519_CR26","doi-asserted-by":"publisher","first-page":"107","DOI":"10.5334\/aogh.3784","volume":"88","author":"L Samad","year":"2022","unstructured":"Samad L, Ashraf MN, Mohammad AA, Fatima I, Fowler Z, Albutt K, et al. Access and financial burden for patients seeking essential surgical care in Pakistan. Ann Glob Health. 2022;88(1):107.","journal-title":"Ann Glob Health"},{"issue":"7","key":"15519_CR27","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1200\/JCO.2013.51.8480","volume":"32","author":"TD Shanafelt","year":"2014","unstructured":"Shanafelt TD, Gradishar WJ, Kosty M, Satele D, Chew H, Horn L, et al. Burnout and career satisfaction among US oncologists. J Clin Oncol. 2014;32(7):678\u201386.","journal-title":"J Clin Oncol"},{"key":"15519_CR28","volume-title":"Burn-out an occupational phenomenon: International Classification of Diseases","author":"World Health Organization","year":"2019","unstructured":"World Health Organization. Burn-out an occupational phenomenon: International Classification of Diseases. Geneva: WHO; 2019."},{"issue":"S6","key":"15519_CR29","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12911-021-01534-6","volume":"21","author":"JE Harrison","year":"2021","unstructured":"Harrison JE, Weber S, Jakob R, Chute CG. ICD-11: an international classification of diseases for the twenty-first century. BMC Med Inf Decis Mak. 2021;21(S6):206.","journal-title":"BMC Med Inf Decis Mak"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-026-15519-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15519-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15519-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T17:01:49Z","timestamp":1788800509000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12913-026-15519-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,5]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["15519"],"URL":"https:\/\/doi.org\/10.1186\/s12913-026-15519-6","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,5]]},"assertion":[{"value":"20 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board Committee of Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan (reference No. F.2\u201381\/2025-GENL\/428\/JPMC;). The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants prior to their participation in the survey.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1240"}}