Study of the Oncology Workforce Seeks to Determine US Cancer Care Needs for the Future

Will there be a shortage of oncologists in 2015? This is a question that needs to be answered now in order to design and promote programs and policies that can help assure that Americans have access to high-quality cancer care in the future. All signs point to a significant increase in cancer rates as the baby boomers reach 65 years of age and older.[1] Additionally, the 5-year survival rate has risen to 79% for children and 64% for adults[2] and will likely lead to a significant rise in individuals with a need for continuing care and observation.

Comprehensive Assessment

Yet the production of new clinical oncologists has remained fairly constant (400 to 500 per year[3]) over the past decade, and we do not know how many of today's practicing oncologists will still be seeing patients in 2015. While there seems to be growing interest in clinical oncology fellowships among medical students and residents,[4] we do not know whether the numbers of training/fellowship positions will produce enough clinical oncologists to meet future needs.

In order to conduct a comprehensive assessment of the current and likely future supply and demand for practicing oncologists, the American Society for Clinical Oncology (ASCO) has contracted with the Association of American Medical Colleges' (AAMC) Center for Workforce Studies. The Center is conducting the study in cooperation with the ASCO Workforce in Oncology Task Force, chaired by Michael Goldstein, MD, a medical oncologist at Beth Israel Deaconess Medical Center, Boston. The Task Force includes leaders representing a number of areas: program directors, oncology fellows, health services researchers, community oncologists, academic oncologists, and workforce specialists.

Main Areas of Focus

The 18-month study focuses on medical oncologists, hematologists/oncologists, gynecologic oncologists, and pediatric hematologists/oncologists. The study includes a detailed analysis of existing data on the incidence of cancer and current utilization patterns and incorporates new knowledge on practice patterns and career expectations gathered from surveys of practicing clinical oncologists, program directors, fellows completing training, and new entrants in fellowship programs. Information gathered from the study will be used to model future supply and demand. The study contains four main areas of focus:

(1) Assessment of the supply and distribution of the oncologist workforce, including geographic and demographic data on oncologists currently in practice and a survey of attitudes of practicing oncologists regarding factors influencing physician supply and productivity;

(2) Assessment of oncologists in training, including demographic data for applicants to fellowship programs and surveys of fellows entering and graduating from fellowship programs and program directors to determine initial career choices and expectations;

(3) Analysis of existing oncology data, including age-specific cancer incidence rates, population projections and Medicare claims data; and

(4) Projection of future oncologist workforce needs, taking into account projected cancer incidence and prevalence and adjusting for factors influencing oncologist supply and productivity.

Results of the study will be released in February/March 2007, with a presentation of study results planned for the 2007 ASCO Annual Meeting. For additional information on the study, contact ASCO's Cancer Research Division of the Cancer Policy and Clinical Affairs Department at cancerresearch@asco.org.

References:

1. US Cancer Statistics Working Group: United States Cancer Statistics: 2000 Incidence Report. Atlanta, Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute, 2003.

2. US Centers for Disease Control and Prevention: Cancer survivorship-United States, 1971-2001. MMWR Morb Mortal Wkly Rep 53:528, 2004.

3. JAMA Medical education issues, 1992-2003.

4. Todd RF, Gitlin SB, Burns LJ, and the Committee on Training Programs: Subspecialty training in hematology and oncology, 2003: Results of a survey of training program directors conducted by the American Society of Hematology. Blood 103:4383-4388, 2004.