The state of cardio-oncology in Oman: awareness, practices, and training needs among healthcare providers: a survey-based study

Cardio-oncology has emerged as a multidisciplinary subspecialty to address the growing burden of cancer therapy–related cardiovascular toxicity and its impact on morbidity and mortality. However, data on awareness, practice patterns, and service availability remain limited. This study aimed to evaluate awareness, clinical practices and service availability related to cardio-oncology among healthcare providers (HCPs) in Oman. We conducted a national, cross-sectional, survey-based study among physicians and clinical pharmacists practicing in Oman between April and December 2025. The structured questionnaire, adapted from previously validated international surveys, assessed awareness of cardio-oncology, availability of services, clinical practices, training exposure, and decision-making using two standardized cardiotoxicity case scenarios. Of 437 invited participants, 124/167 completed the survey. Respondents included cardiologists (n = 48, 38.7%), internal medicine physicians (n = 39, 31.5%), oncologists (n = 23, 18.5%), and clinical pharmacists (n = 14, 11.3%), with the majority practicing in tertiary centers (n = 76, 61.3%). Formal training in cardio-oncology was rare (n = 4, 3.6%). Overall awareness of cardio-oncology was moderate to high. Most participants recognized key domains, including management of cancer therapy–related cardiac complications (n = 109, 88.0%), identification of cardiotoxicity and referral (n = 106, 86.0%), and risk stratification (n = 105, 85.0%). However, awareness was lower for survivorship care (n = 77, 62.0%) and patient education (n = 72, 58.0%). Composite awareness was observed in 64% (≥ 3 domains) and 51% (all domains), with significantly higher awareness in tertiary centers compared to secondary settings (57.9% vs. 18.8%, p < 0.001). Cardio-oncology services were limited: 35% reported general cardiology-led care, while only 17.9% reported access to specialized services; 33.3% were uncertain about service availability. Major barriers included limited funding and infrastructure. Most respondents emphasized the importance of cardiotoxicity assessment during cancer care (very important: 74.4% pre-treatment, 75.6% during treatment). While 50.6% supported routine cardiology monitoring even in low-risk patients, practices regarding cardioprotective therapy varied. The majority (78.3%) believed that access to cardio-oncology services would significantly improve patient outcomes. Cardiologists reported significantly higher confidence and more consistent management of cardiotoxicity than oncologists (p < 0.05). Although healthcare providers in Oman demonstrate moderate awareness of cardio-oncology, significant gaps remain in structured training, service availability, and survivorship-focused care. Establishing dedicated multidisciplinary cardio-oncology programs and targeted educational initiatives is essential to bridge the gap between knowledge and clinical implementation and to optimize cardiovascular outcomes for patients receiving cancer therapy.