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ASCO Report: U.S. Could Face Shortage of Cancer Doctors

Document examines factors affecting America’s ability to provide high-quality cancer care

The demand for cancer treatments is expected to grow by 42% or more by 2025, while the supply of oncologists will increase by only 28%, according to a new report from the American Society of Clinical Oncology (ASCO).

The State of Cancer Care in America: 2014 examines the many factors that affect America’s ability to provide high-quality cancer prevention and treatment services, from current and projected demand for services and oncologist workforce supply to the full range of economic, regulatory and administrative pressures that oncology practices face.

The report notes that the demand for cancer prevention, screening, and treatment services is growing rapidly. By 2030, the number of new cancer cases in the U.S. will increase by 45% and cancer will become the nation’s leading cause of death, largely as a result of the aging of the nation’s population. At the same time, the number of cancer survivors, now at 13.7 million, will continue to grow. Many of these individuals will require significant, ongoing care.

Moreover, access to quality cancer care remains uneven, according to the report. Millions of people with cancer lack access to quality medical care, and rates of access to care are disproportionately lower for African-Americans and Latinos. Today, one quarter of uninsured individuals forego care because of cost, and those without a regular source of care are less likely to receive cancer screening.

The Patient Protection and Affordable Care Act (PPACA) is expected to provide millions more Americans with health insurance coverage in the coming years. However, according to the report, the PPACA alone may not solve disparities in cancer care — partly because it places significant emphasis on expanding Medicaid coverage, which has been associated with poor outcomes for patients with cancer. In addition, millions of Americans are expected to remain uninsured even after the PPACA is implemented.

With regard to potential workforce shortages, ASCO finds that there could be a shortage of more than 1,487 oncologists by 2025. Shortfalls will be driven by significant growth in the number of Americans over the age of 65, along with the aging of the oncology workforce and large numbers of anticipated retirements. In addition, ASCO’s research indicates that these shortfalls may be further exacerbated by high levels of physician burnout, potentially leading to reduced clinical loads or early retirement.

To ensure continued availability of oncology services for patients nationwide, ASCO recommends the following:

  • Identify creative strategies for leveraging the oncology workforce — for example, collaboration with primary care professionals on overall coordination of patients’ cancer care, allowing oncologists to focus on patients receiving active treatment of the disease.
  • Leverage technology and innovative practice models, such as telemedicine and visiting consultants to improve patient access and to better connect other providers to cancer specialists.
  • Monitor and address physician burnout. Professional organizations should explore ways that burnout can be prevented and/or addressed and should encourage confidential reporting of burnout to gain a more accurate understanding of this challenge.
  • Monitor and address the size and diversity of the oncology workforce. It is important to increase the number of oncologists from under-represented racial and ethnic groups, ASCO says. Today, there are lower percentages of African- and Latino-American physicians in oncology than in many other medical specialties.

Source: ASCO; March 11, 2014.

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