HOUSTON - Between 2010 and 2020, the demand for radiation
therapy will exceed the number of radiation oncologists practicing
in the U.S. tenfold, which could profoundly affect the ability to
provide patients with sufficient access to treatment, according to
new research from The University of Texas MD Anderson Cancer
Center.
The study, published in the October 18, 2024 issue of The
Journal of Clinical Oncology, estimates that over the next
decade, the number of cancer patients requiring radiation therapy
will increase by 22 percent, while the number of full-time
equivalent radiation oncologists entering the workforce will
increase by just two percent. Researchers based their calculations
on projections that in 2010, 3,943 radiation oncologists will treat
an estimated 470,000 patients in the U.S.
According to Benjamin Smith, M.D., assistant professor in the
Department of Radiation Oncology at MD Anderson and lead author of
the study, radiation therapy is critical in the cancer care
continuum, making the need for solutions that will resolve the gap
a priority to continue providing the best cancer care possible.
With this in mind, researchers also outlined stop-gap measures to
address the shortage, including adopting more team-care models,
altering the length of treatment and gradually increasing the size
of residency training programs.
The findings add to the growing body of literature compiled by
the American Society for Clinical Oncology and other organizations
on the projected shortage of cancer doctors over the next ten
years, which is driven largely by demographic changes, including an
increase in older adults and minorities, groups in which certain
cancers are more prevalent. Data from the study approximates that
the need for radiation therapy for adults ages 65 and older will
increase 38 percent; for minorities, demand will increase by 45
percent.
"Shortages mean double trouble," said Smith. "Since research has
shown that a delay between diagnosis and the start of radiation
therapy can reduce its effectiveness, oncologists and radiologists
must collaborate even more so the quality of care doesn't break
down at multiple points."
Further research is needed to determine how practices can be
changed to accommodate more patients and better provide radiation
therapy without compromising quality of and access to care, Smith
said. In the paper, the researchers offered several strategies to
offset the shortage:
- Adopt a patient management team model: Incorporating physician
assistants and/or advanced practice registered nurses to assist
physicians in caring for patients receiving radiation therapy in
order to increase the number of patients who can receive care at
the same time;
- Provide shorter radiation treatment courses: In many
situations, shorter treatment courses have been proven to be more
efficient than, and just as effective as, long course radiation;
and
- Increase the size of residency programs: A gradual increase in
the number of trainees admitted to programs would help to increase
the number of radiation oncologists available to treat patients
over the next ten years.
Smith and colleagues estimated demand for radiation therapy by
multiplying the current use of radiation therapy by population
projections. To project the number of radiation oncologists in
2020, researchers examined the current number of board certified
radiation oncologists and active residents who would become
certified by 2014, being sensitive to age and gender, to determine
approximate retirement age and full-time status. This model was
then used to simulate the class composition for the remainder of
the decade.
To measure the demand for radiation therapy and the supply of
radiation oncologists, researchers used figures on current
radiation therapy use and population projections from the
Surveillance, Epidemiology and End Results (SEER)-17 database, the
U.S. Census and American Board of Radiology data on the current
workforce and trainees.
"For the first time, we have a clearer sense of how a shortage
in the oncology field may play out," said Smith. "While our
projections in the number of full time practicing radiation
oncologists are the most accurate to date, the actual gap between
patients and radiation oncologists will depend on the role of and
need for radiation therapy in the future."
SOURCE