Expert range maps of global mammal distributions harmonised to three taxonomic authorities

Aim: Comprehensive, global information on species' occurrences is an essential biodiversity variable and central to a range of applications in ecology, evolution, biogeography and conservation. Expert range maps often represent a species' only available distributional information and play an increasing role in conservation assessments and macroecology. We provide global range maps for the native ranges of all extant mammal species harmonised to the taxonomy of the Mammal Diversity Database (MDD) mobilised from two sources, the Handbook of the Mammals of the World (HMW) and the Illustrated Checklist of the Mammals of the World (CMW). Location: Global. Taxon: All extant mammal species. Methods: Range maps were digitally interpreted, georeferenced, error-checked and subsequently taxonomically aligned between the HMW (6253 species), the CMW (6431 species) and the MDD taxonomies (6362 species). Results: Range maps can be evaluated and visualised in an online map browser at Map of Life (mol.org) and accessed for individual or batch download for non-commercial use. Main conclusion: Expert maps of species' global distributions are limited in their spatial detail and temporal specificity, but form a useful basis for broad-scale characterizations and model-based integration with other data. We provide georeferenced range maps for the native ranges of all extant mammal species as shapefiles, with species-level metadata and source information packaged together in geodatabase format. Across the three taxonomic sources our maps entail, there are 1784 taxonomic name differences compared to the maps currently available on the IUCN Red List website. The expert maps provided here are harmonised to the MDD taxonomic authority and linked to a community of online tools that will enable transparent future updates and version control.Fil: Marsh, Charles J.. Yale University; Estados UnidosFil: Sica, Yanina. Yale University; Estados UnidosFil: Burguin, Connor. University of New Mexico; Estados UnidosFil: Dorman, Wendy A.. University of Yale; Estados UnidosFil: Anderson, Robert C.. University of Yale; Estados UnidosFil: del Toro Mijares, Isabel. University of Yale; Estados UnidosFil: Vigneron, Jessica G.. University of Yale; Estados UnidosFil: Barve, Vijay. University Of Florida. Florida Museum Of History; Estados UnidosFil: Dombrowik, Victoria L.. University of Yale; Estados UnidosFil: Duong, Michelle. University of Yale; Estados UnidosFil: Guralnick, Robert. University Of Florida. Florida Museum Of History; Estados UnidosFil: Hart, Julie A.. University of Yale; Estados UnidosFil: Maypole, J. Krish. University of Yale; Estados UnidosFil: McCall, Kira. University of Yale; Estados UnidosFil: Ranipeta, Ajay. University of Yale; Estados UnidosFil: Schuerkmann, Anna. University of Yale; Estados UnidosFil: Torselli, Michael A.. University of Yale; Estados UnidosFil: Lacher, Thomas. Texas A&M University; Estados UnidosFil: Wilson, Don E.. National Museum of Natural History; Estados UnidosFil: Abba, Agustin Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Estudios Parasitológicos y de Vectores. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Estudios Parasitológicos y de Vectores; ArgentinaFil: Aguirre, Luis F.. Universidad Mayor de San Simón; BoliviaFil: Arroyo Cabrales, Joaquín. Instituto Nacional de Antropología E Historia, Mexico; MéxicoFil: Astúa, Diego. Universidade Federal de Pernambuco; BrasilFil: Baker, Andrew M.. Queensland University of Technology; Australia. Queensland Museum; AustraliaFil: Braulik, Gill. University of St. Andrews; Reino UnidoFil: Braun, Janet K.. Oklahoma State University; Estados UnidosFil: Brito, Jorge. Instituto Nacional de Biodiversidad; EcuadorFil: Busher, Peter E.. Boston University; Estados UnidosFil: Burneo, Santiago F.. Pontificia Universidad Católica del Ecuador; EcuadorFil: Camacho, M. Alejandra. Pontificia Universidad Católica del Ecuador; EcuadorFil: de Almeida Chiquito, Elisandra. Universidade Federal do Espírito Santo; BrasilFil: Cook, Joseph A.. University of New Mexico; Estados UnidosFil: Cuéllar Soto, Erika. Sultan Qaboos University; OmánFil: Davenport, Tim R. B.. Wildlife Conservation Society; TanzaniaFil: Denys, Christiane. Muséum National d'Histoire Naturelle; FranciaFil: Dickman, Christopher R.. The University Of Sydney; AustraliaFil: Eldridge, Mark D. B.. Australian Museum; AustraliaFil: Fernandez Duque, Eduardo. University of Yale; Estados UnidosFil: Francis, Charles M.. Environment And Climate Change Canada; CanadáFil: Frankham, Greta. Australian Museum; AustraliaFil: Freitas, Thales. Universidade Federal do Rio Grande do Sul; BrasilFil: Friend, J. Anthony. Conservation And Attractions; AustraliaFil: Giannini, Norberto Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; ArgentinaFil: Gursky-Doyen, Sharon. Texas A&M University; Estados UnidosFil: Hackländer, Klaus. Universitat Fur Bodenkultur Wien; AustriaFil: Hawkins, Melissa. National Museum of Natural History; Estados UnidosFil: Helgen, Kristofer M.. Australian Museum; AustraliaFil: Heritage, Steven. University of Duke; Estados UnidosFil: Hinckley, Arlo. Consejo Superior de Investigaciones Científicas. Estación Biológica de Doñana; EspañaFil: Holden, Mary. American Museum of Natural History; Estados UnidosFil: Holekamp, Kay E.. Michigan State University; Estados UnidosFil: Humle, Tatyana. University Of Kent; Reino UnidoFil: Ibáñez Ulargui, Carlos. Consejo Superior de Investigaciones Científicas. Estación Biológica de Doñana; EspañaFil: Jackson, Stephen M.. Australian Museum; AustraliaFil: Janecka, Mary. University of Pittsburgh at Johnstown; Estados Unidos. University of Pittsburgh; Estados UnidosFil: Jenkins, Paula. Natural History Museum; Reino UnidoFil: Juste, Javier. Consejo Superior de Investigaciones Científicas. Estación Biológica de Doñana; EspañaFil: Leite, Yuri L. R.. Universidade Federal do Espírito Santo; BrasilFil: Novaes, Roberto Leonan M.. Universidade Federal do Rio de Janeiro; BrasilFil: Lim, Burton K.. Royal Ontario Museum; CanadáFil: Maisels, Fiona G.. Wildlife Conservation Society; Estados UnidosFil: Mares, Michael A.. Oklahoma State University; Estados UnidosFil: Marsh, Helene. James Cook University; AustraliaFil: Mattioli, Stefano. Università degli Studi di Siena; ItaliaFil: Morton, F. Blake. University of Hull; Reino UnidoFil: Ojeda, Agustina Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Ordóñez Garza, Nicté. Instituto Nacional de Biodiversidad; EcuadorFil: Pardiñas, Ulises Francisco J.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Diversidad y Evolución Austral; ArgentinaFil: Pavan, Mariana. Universidade de Sao Paulo; BrasilFil: Riley, Erin P.. San Diego State University; Estados UnidosFil: Rubenstein, Daniel I.. University of Princeton; Estados UnidosFil: Ruelas, Dennisse. Museo de Historia Natural, Lima; PerúFil: Schai-Braun, Stéphanie. Universitat Fur Bodenkultur Wien; AustriaFil: Schank, Cody J.. University of Texas at Austin; Estados UnidosFil: Shenbrot, Georgy. Ben Gurion University of the Negev; IsraelFil: Solari, Sergio. Universidad de Antioquia; ColombiaFil: Superina, Mariella. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Tsang, Susan. American Museum of Natural History; Estados UnidosFil: Van Cakenberghe, Victor. Universiteit Antwerp; BélgicaFil: Veron, Geraldine. Université Pierre et Marie Curie; FranciaFil: Wallis, Janette. Kasokwa-kityedo Forest Project; UgandaFil: Whittaker, Danielle. Michigan State University; Estados UnidosFil: Wells, Rod. Flinders University.; AustraliaFil: Wittemyer, George. State University of Colorado - Fort Collins; Estados UnidosFil: Woinarski, John. Charles Darwin University; AustraliaFil: Upham, Nathan S.. University of Yale; Estados UnidosFil: Jetz, Walter. University of Yale; Estados Unido

Research on armadillos: a review and prospectus

A detailed analysis of 1,039 scientific studies of extant armadillos (Xenarthra: Cingulata, Dasypodidae) published in the last 25 years (1989?2013) revealed substantial biases in coverage, including taxonomically, the locales where field studies were conducted, and in the topics investigated.  Examination of the number of other publications that cited each paper revealed that 470 (45%) papers had been cited no more than 10 times, 249 (24%) had never been cited, and 112 (11%) were not even found in the Google ScholarTM database.  The most heavily cited papers were molecular phylogenetic analyses that often used tissues from one or more species of armadillo but were not about the animals per se.  Thus, it appears that research on armadillos is plagued by numerous gaps in coverage, and is not reaching a wide audience.  These data indicate obvious opportunities for future research.  In addition, recent findings suggest that even relatively well-studied phenomena may require re-examination.  Here we review recent advances in the study of armadillos and highlight promising areas for future work.  One critical need is for a thorough systematic revision of Dasypodidae to be completed.  This will make it possible to prioritize those species and populations most in need of study.  Additionally, more long-term field studies of populations of marked individuals are required.  Although there are many important and interesting questions waiting to be answered, the small number of researchers currently conducting studies of armadillos, particularly in the wild, means that progress will be slow.Un análisis detallado de 1.039 estudios científicos sobre armadillos actuales (Xenarthra: Cingulata, Dasypodidae), que fueron publicados en los últimos 25 años (1989–2013), mostró que existen considerables sesgos en la cobertura, incluyendo la taxonomía, los lugares donde se realizaron los estudios de campo, y en los temas estudiados. El análisis de la cantidad de otros trabajos que citaron las publicaciones de armadillos mostró que 470 (45%) de los artículos fueron citado no más de 10 veces, 249 (24%) nunca habían sido citado y 112 (11%) ni siquiera fueron encontrado en la base de datos de Google Scholar. Las publicaciones citadas con mayor frecuencia describían análisis filogenéticos moleculares que generalmente utilizaban tejidos de una o más especies de armadillos, pero no trataban de los armadillos per se. Pareciera, entonces, que la investigación en armadillos está plagada de numerosos vacíos en la cobertura y no está alcanzando una amplia audiencia. Estos datos indican claras oportunidades para futuras investigaciones. Adicionalmente, recientes hallazgos sugieren que incluso las peculiaridades relativamente bien estudiadas podrían requerir de análisis adicionales. En este trabajo revisamos recientes avances en el estudio de los armadillos y resaltamos áreas prometedoras para futuras investigaciones. Una de las necesidades críticas es el desarrollo de una detallada revisión sistemática de los Dasypodidae que permitirá priorizar las especies y poblaciones con mayor necesidad de investigación. Adicionalmente, se requieren de estudios a largo plazo que involucren poblaciones de individuos marcados. Si bien existen muchas preguntas importantes e interesantes que esperan ser respondidas, el reducido número de investigadores que actualmente desarrollan estudios sobre armadillos, especialmente a campo, parece prever que será un proceso lento.Fil: Loughry, W. J.. Valdosta State University; Estados UnidosFil: Superina, Mariella. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: McDonough, Colleen M.. Valdosta State University; Estados UnidosFil: Abba, Agustin Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de la Plata. Facultad de Ciencias Naturales y Museo. Departamento Científico Zoología Vertebrados; Argentin

Los mamíferos amenazados del Paraguay

Se evaluaron 178 especies, excluyendo al tapiti Sylvilagus brasiliensis y al Dasypus septemcinctus (ver capítulo Xenarthra). Entre las especies evaluadas, se resalta que 29 especies fueron catalogadas como ?datos insuficientes? o DI, esto significa que la información disponible sobre estas especies en nuestro país es tan escasa que no podemos definir cuál es su estado de conservación a nivel nacional. Esta situación se debe a que existen pocos registros de la especie hasta el momento, pero la causa de ello es desconocida. Se podría Dar el caso de que la especie dada tenga una población abundante, pero hay pocas investigaciones (o ninguna) realizadas sobre el tema o bien, o caso contrario, que las especies posean pequeños tamaños poblacionales, sean de difícil avistamiento por lo que el esfuerzo de muestreo es escaso o inexistente (no se los busco). Esto resalta la importancia de la investigación en mastozoología para poder tomar decisiones de conservación, ya que, sin investigación científica, es imposible trazar acciones de conservación prácticas y fiables a nivelpaís y regional.Fil: Saldivar, S.. Asociación Paraguaya de Mastozoología; ParaguayFil: Rojas, V.. Asociación Paraguaya de Mastozoología; Paraguay. Asociacion Guyra Paraguay (guyra); Paraguay. Programa Nacional de Incentivo a los Investigadores; ParaguayFil: Giménez, D.. Asociación Paraguaya de Mastozoología; Paraguay. Sociedad para la Preservación de Carnívoros en Peligro y su Estudio Ecológico Internacional; Estados UnidosFil: Abba, Agustin Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Estudios Parasitológicos y de Vectores. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Estudios Parasitológicos y de Vectores; ArgentinaFil: Ayala, R.. Universidad de Buenos Aires; Argentina. Asociación Paraguaya de Mastozoología; ParaguayFil: Barreto, R.. Secretaría del Ambiente; ParaguayFil: Cartes, J.L.. Asociación Paraguaya de Mastozoología; Paraguay. Asociacion Guyra Paraguay (guyra); Paraguay. Programa Nacional de Incentivo a los Investigadores; ParaguayFil: del Castillo, H.. Asociacion Guyra Paraguay (guyra); Paraguay. Programa Nacional de Incentivo a los Investigadores; ParaguayFil: Cuéllar, E.. No especifíca;Fil: de la Sancha, N.U.. Asociación Paraguaya de Mastozoología; Paraguay. Chicago State University; Estados Unidos. Field Museum of National History; Estados UnidosFil: Gamarra de Fox, I.. Asociación Paraguaya de Mastozoología; Paraguay. Secretaría del Ambiente; ParaguayFil: Giordano, A.J.. Sociedad para la Preservación de Carnívoros en Peligro y su Estudio Ecológico Internacional; Estados UnidosFil: Kowalewski, Miguel Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: López, J.. Asociación Paraguaya de Mastozoología; Paraguay. Universidad de Buenos Aires; ArgentinaFil: Martínez, V.. Asociación Paraguaya de Mastozoología; Paraguay. Itaipu Binacional; ParaguayFil: Mujica, N.. Universidad Nacional de Asunción; ParaguayFil: Neris, N.. Asociación Paraguaya de Mastozoología; Paraguay. Secretaría del Ambiente; ParaguayFil: Ortiz, M.L.. Asociación Paraguaya de Mastozoología; ParaguayFil: Ramírez, F.. Asociación Paraguaya de Mastozoología; Paraguay. Fundación Moisés Bertoni; ParaguayFil: Ríos, S.D.. Asociación Paraguaya de Mastozoología; Paraguay. Secretaría Nacional de Cultura; ParaguayFil: Ruíz Díaz, M.. Asociación Paraguaya de Mastozoología; ParaguayFil: Sánchez, J.. Asociación Paraguaya de Mastozoología; Paraguay. Universidad Nacional de Asunción; ParaguayFil: Smith, P.. Asociación Paraguaya de Mastozoología; Paraguay. Programa Nacional de Incentivo a los Investigadores; ParaguayFil: Stevens, R.. Texas Tech University; Estados UnidosFil: Teta, Pablo Vicente. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Thompson, J.J.. Asociación Paraguaya de Mastozoología; Paraguay. Asociacion Guyra Paraguay (guyra); ParaguayFil: Torres, J.. Asociación Paraguaya de Mastozoología; ParaguayFil: Velázquez, M.. Asociación Paraguaya de Mastozoología; Paraguay. Fundación Moisés Bertoni; ParaguayFil: Velilla, M.. Asociación Paraguaya de Mastozoología; Paraguay. Asociacion Guyra Paraguay (guyra); Paraguay. Programa Nacional de Incentivo a los Investigadores; ParaguayFil: Villalba, L.. Asociación Paraguaya de Mastozoología; Paraguay. Wildlife Conservation Society; ParaguayFil: Weiler, A.. Asociación Paraguaya de Mastozoología; Paraguay. Programa Nacional de Incentivo a los Investigadores; Paraguay. Universidad Nacional de Asunción; Paragua

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research