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Current and Future Utilization of Services From Medical Oncologists

Joan L. Warren, Angela B. Mariotto, Angela Meekins, Marie Topor, Martin L. Brown

From the Applied Research Program, and the Surveillance Research Program, National Cancer Institute, Bethesda; and Information Management Services, Silver Spring, MD

Corresponding author: Joan L. Warren, PhD, Health Services and Economics Branch/Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Executive Plaza North, Rm 4005, 6130 Executive Blvd, MSC 7344, Bethesda, MD 20892-7344; e-mail: joan_warren{at}nih.gov

Purpose There is limited information on the current use of oncologists and projections of future need. This analysis assesses current utilization patterns and projects the number of people with cancer and their use of oncologists’ services through 2020.

Methods Data from the Surveillance, Epidemiology, and End Results cancer registries and Medicare physician claims were used to estimate oncologists’ services from 1998 to 2003. We estimated the portion of patients with cancer who saw an oncologist, the mean number of visits, and the clinical setting where care was provided. Care was divided into initial, continuing, and last-year-of-life phases. Projections for future number of patients with cancer and visits were calculated by applying incidence and prevalence rates derived from Surveillance, Epidemiology, and End Results data to census population projections through 2020.

Results The percentage of patients who saw an oncologist was 47% during the initial-care phase, 36% during the continuing-care phase, and 70% in the last year of life. The number of visits varied by age, sex, cancer site, and phase. The total number of cancer patients in the United States is projected to increase 55%, from 11.8 million in 2005 to 18.2 million in 2020. Total oncology visits are projected to increase from 38 million in 2005 to 57 million in 2020.

Conclusion Utilization of oncologists’ services will increase appreciably between 2005 and 2020; this will be driven predominantly by an increase in survivors of cancer and by the aging of the population. The United States may face an acute shortage of medical oncologists if efforts are not taken to meet this growing need.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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