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Cancer Care and Cancer Survivorship Care in the United States: Will We Be Able to Care for These Patients in the Future?

Lance Armstrong Foundation and the LIVESTRONG Survivorship Center of Excellence Network; Dana-Farber Cancer Institute, Boston, MA; University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA; Center for Health Policy Research, University of California, Irvine, Irvine; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; University of Texas, Austin, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; Ohio State University, Columbus, OH; University of Colorado Cancer Center, Denver, CO; Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC; and Yale University, New Haven, CT

Corresponding author: Lawrence N. Shulman, MD, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115; Lawrence_Shulman{at}dfci.harvard.edu

Studies have predicted a shortfall in the workforces of oncologists and primary care physicians in the coming years. These estimates are based on the number of current physicians, those leaving the profession, and the rate of new physicians joining each profession, as benchmarked against the number of patients needing care. For active cancer treatment, and particularly for the care of cancer survivors, it is likely that current calculations underestimate the shortfalls which will occur in the next 5 to 10 years. Ever more complex cancer therapies are leading to better outcomes with improved cure rates and prolonged survivals even for patients who ultimately succumb to their disease, resulting in a substantial increase in utilization of health care resources. Due to these factors, utilization of health care resources by cancer patients and cancer survivors is climbing at a rate greater than would be predicted by patient numbers alone. The combination of an increased number of patients utilizing more resources calls into question the ability of our healthcare system to meet the needs of cancer patients and cancer survivors in the future. It is crucial that innovative models of care (utilizing nonphysician providers) be developed and evaluated to assure quality care and services for this growing population.

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