JCO: Rad oncologist shortage spells 'double trouble'
Clarity image-guided radiation therapy for patient.
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Demand for radiation therapy is expected to exceed the capacity of radiation oncologists by tenfold between 2010 and 2020, according to a study published Oct. 18 in the Journal of Clinical Oncology.

The number of patients that will require radiation therapy is estimated to increase by 22 percent, while the number of radiation oncologists is expected to grow by just 2 percent over the same 10-year period, the study reported.

The shortage has implications for patient care and practice patterns between radiation oncologists and radiologists. The study identified several strategies that might mitigate the impact of the projected shortage.

Benjamin Smith, MD, of the department of radiation oncology at the University of Texas MD Anderson Cancer Center in Houston, and colleagues estimated demand for radiation therapy by multiplying current cancer figures by the projected population growth over the next ten years. The number of radiation oncologists was approximated by looking at workforce ages, expected retirements and the number of residents anticipated to be board certified by 2014. The study's sources included the U.S. Census Bureau, the Surveillance, Epidemiology and End Results (SEER)-17 database and the American Board of Radiology.

The authors estimated that population growth in elderly patients and minorities, whose demand for radiation therapy is projected to increase by 38 percent and 45 percent, respectively, would account for a large portion of the growth in demand because both demographics have high cancer rates.

"Shortages mean double trouble," Smith stated. "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."

While calling on the need for more research to find ways to accommodate increasing numbers of patients without compromising quality of care or access to care, the authors made several recommendations:
  • Adopt a patient management team model, incorporating more physician assistants and advanced practice registered nurses to assist physicians in patient care;
  • Provide shorter treatment courses, since in many cases shorter courses have been shown to be more efficient and equally effective as long-course radiation; and
  • Increase the size of residency programs, as a gradual increase in trainees could help meet some of the growing demand for radiation oncologists.

"For the first time, we have a clearer sense of how a shortage in the oncology field may play out," Smith concluded, while pointing out that the actual gap between demand and supply of radiation oncologists will depend to some extent on various factors over the next 10 years.