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Cited by 528Advances in Oncology and RadiotherapyGlobal Health Workforce IssuesDiversity and Career in Medicine

Future supply and demand for oncologists: challenges to assuring access to oncology services

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Erikson, Clese, Salsberg, Edward, Forte, Gaetano, Bruinooge, Suanna, Goldstein, Michael·2007·Journal of Oncology Practice
DOI 10.1200/jop.0723601PMC PMC2793740
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Abstract

Purpose: To conduct a comprehensive analysis of supply of and demand for oncology services through 2020. This study was commissioned by the Board of Directors of ASCO. Methods: New data on physician supply gathered from surveys of practicing oncologists, oncology fellows, and fellowship program directors were analyzed, along with 2005 American Medical Association Masterfile data on practicing medical oncologists, hematologists/oncologists, and gynecologic oncologists, to determine the baseline capacity and to forecast visit capacity through 2020. Demand for visits was calculated by applying age-, sex-, and time-from-diagnosis-visit rate data from the National Cancer Institute's analysis of the 1998 to 2002 Surveillance, Epidemiology and End Results (SEER) database to the National Cancer Institute's cancer incidence and prevalence projections. The cancer incidence and prevalence projections were calculated by applying a 3-year average (2000–2002) of age- and sex-specific cancer rates from SEER to the US Census Bureau population projections released on March 2004. The baseline supply and demand forecasts assume no change in cancer care delivery and physician practice patterns. Alternate scenarios were constructed by changing assumptions in the baseline models. Results: Demand for oncology services is expected to rise rapidly, driven by the aging and growth of the population and improvements in cancer survival rates, at the same time the oncology workforce is aging and retiring in increasing numbers. Demand is expected to rise 48% between 2005 and 2020. The supply of services provided by oncologists during this time is expected to grow more slowly, approximately 14%, based on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions. This translates into a shortage of 9.4 to 15.0 million visits, or 2,550 to 4,080 oncologists—roughly one-quarter to one-third of the 2005 supply. The baseline projections do not include any alterations based on changes in practice patterns, service use, or cancer treatments. Various alternate scenarios were also developed to show how supply and demand might change under different assumptions. Conclusions: ASCO, policy makers, and the public have major challenges ahead of them to forestall likely shortages in the capacity to meet future demand for oncology services. A multifaceted strategy will be needed to ensure that Americans have access to oncology services in 2020, as no single action will fill the likely gap between supply and demand. Among the options to consider are increasing the number of oncology fellowship positions, increasing use of nonphysician clinicians, increasing the role of primary care physicians in the care of patients in remission, and redesigning service delivery.

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  • The growing cancer survivor population will strain a healthcare system with frequent cancer drug shortages and oncology demand that is expected to exceed oncologist supply.

    “The growing population of cancer survivors will put pressure on a healthcare system in which cancer drug shortages are increasingly common and the demand for oncology services is poised to outpace the supply of oncologists (4–6).”

    From Cancer Survivors in the United States: Prevalence across the Survivorship Trajectory and Implications for Care (2013) · cites this paper as [4]

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Authors
Erikson, C., Salsberg, E., Forte, G., Bruinooge, S., & Goldstein, M.
ORCID
Venue
Journal of Oncology Practice
Publisher
American Society of Clinical Oncology (ASCO)
Published
2007-03
Volume
3
Issue
2
Pages
79-86
ISSN
  • 1554-7477 (ISSN-L)
  • 1935-469X
DOI
10.1200/jop.0723601
PMC
PMC2793740
OpenAlex
W2108103670
Cited by
528
References
41
Citations by year
2026: 7 · 2025: 12 · 2024: 15 · 2023: 8 · 2022: 27 · 2021: 21 · 2020: 27 · 2019: 25 · 2018: 28 · 2017: 28 · 2016: 42 · 2015: 30 · 2014: 51 · 2013: 45 · 2012: 36
FWCI
23.75
Type
journal article
Language
en
Open access
Locations
  • Journal of Oncology Practice (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords
oncology workforce, physician supply and demand, cancer incidence projections, physician retirement, workforce shortage, cancer care delivery, oncology practice patterns, health workforce planning, SEER database, cancer survival rates, population aging, American Society of Clinical Oncology, United States, 2020 forecast, gynecologic oncologists

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