In a study reported in JCO Oncology Practice, Kirkwood et al identified recent changes in and characteristics of the hematologist/medical oncologist (oncologist) workforce in the United States, with the data revealing gaps in coverage according to age and other patient demographics.
Study Details
The study identified the number of oncologists billing Medicare nationally and by county in 2014 and 2024, with analysis including coverage of individuals aged 55 years and older, in whom 80% of new cancers are diagnosed.
Key Findings
While the number of oncologists billing Medicare increased from 12,267 in 2014 to 14,547 in 2024, the number per 100,000 population aged 55 years and older decreased from 15.9 to 14.9. The density of oncologists per capita has declined in 38 states, with most of those states having limited rural workforce coverage.
At a county level, only 45% of U.S. counties had oncologists present. Those counties with oncologists accounted for 87 million adults aged 55 years and older (89% of ≥ 55 years population). Of these, 478 counties had less than a quarter of oncologists nearing retirement age (21% of the population) and 942 counties had more than a quarter of oncologists nearing retirement age (68% of the population).
Most of the 1,724 counties without oncologists had oncologists in neighboring counties (n = 1,517, accounting for 10% of the ≥ 55 years population). A total of 207 counties had no oncologists in adjacent counties (accounting for 1% of the population).
In total, 89% of the population aged ≥ 55 years lived in counties with oncologists, with 68% of the population living in counties where more than a quarter of oncologists were nearing retirement age. Early-career oncologists were less likely than later-career oncologists to work in counties that were rural or had high rates of cancer mortality, smoking, obesity, social vulnerability, uninsurance, and homes without broadband internet access.
The investigators concluded: “Gaps in oncologist coverage across the country exist, especially among rural populations and those with high cancer burden and socioeconomic risk. Understanding the geographic coverage of oncologists could facilitate efforts to improve patient access to cancer care.”
M. Kelsey Kirkwood, MPH, of the American Society of Clinical Oncology, Alexandria, Virginia, is the corresponding author for the JCO Oncology Practice article.
Disclosure: For full disclosures of all study authors, visit ascopubs.org.
