A Decline in the US Oncology Workforce: What Will the Next Decade Bring?

Rising cancer diagnoses in the US highlight urgent needs for improved oncology education, workforce distribution, and care infrastructure, especially in rural areas.

The number of new cancer diagnoses in the US continues to rise, and estimates exceeded 2 million per year for the first time in 2024.1 As the population ages and life expectancy increases, the cancer risks multiply. In addition to an increased number of cancer diagnoses, the number and complexity of cancer therapy options have dramatically expanded over the past decade. The distribution of the oncology workforce is very uneven, with patients often needing to travel many hours 1 way for oncology care in more rural and remote areas. American Society of Clinical Oncology (ASCO) surveys have demonstrated that metropolitan counties are expected to have adequate oncology capacity by 2037 (102%), but nonmetropolitan areas are expected to have an extremely limited oncology workforce (29%).2 Surveys have also demonstrated a high rate of physician burnout related not only to the complex oncology treatment options but also the administrative burden of modern US health care.3 All these issues have placed a big strain on the US oncology workforce and health care systems.

What is the best path forward to improve these issues? The medical educational system will need to evolve starting at an exceedingly early time point in the educational process. Offering outreach opportunities and career optimization at an early stage in medical education often improves the number of medical students who later elect to go into a specific area of clinical care and research. Some examples are a few new medical schools in less populated areas of the country–sometimes with affiliations with local or distant campuses to support the educational opportunities. This type of medical education may allow applicants to become familiar with the rural population and lifestyle. Therefore, when their medical education is completed, they might consider practicing medicine in a more rural area. Another way to improve the oncology health care system is for physicians to partner with institutions to enhance the infrastructure for oncology, including an electronic medical record (EMR) and support staff specifically designed for oncology care.The addition of advanced practice providers (APPs) with specific training in oncology also improves oncology care and throughput.

Lastly, the health care system will need to work side by side with the hematology/oncology workforce to improve throughput. Modifications of the EMR to oncology-specific modules, addition of oncology APPs to the practice, and competitive compensation and infrastructure are key to enhancing the oncology workforce for the next several decades. Cancer clinical trials are also an important aspect to all of oncology care and must be supported, including in rural areas. The next decade will be key to the future of oncology care in the US.

References

1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49. doi:10.3322/caac.21820
2. Kirkwood MK, Balogh EP, Accordino MK ,et al. Where have we been and where are we going?the state of the hematology and medical oncologist workforce in America.JCO Oncol Pract. Published Online October 7, 2025. doi:10.1200/OP-25-00144
3. Sinsky CA, Brown RL, Rotenstein L, et al. Association of work control with burnout and career intentions among US physicians: a multi-institution study.Ann Intern Med. 2025;178(1):20-28. doi:10.7326/ANNALS-24-00884