By Linda Carroll

(Reuters Health) – As cancer rates rise worldwide, researchers predict a shortage of specialists who can deliver chemotherapy, according to a new study.

World Health Organization projections suggest that the number of people who will need chemotherapy will rise steadily over coming decades. Unless something is done, there won’t be enough specialists to deliver those life-saving treatments, researchers report in The Lancet Oncology.

The number of patients who should be getting chemotherapy is expected to rise from 9.8 million to 15 million by 2040, the Australian researchers noted. And two-thirds of those patients will be from low- and middle-income countries.

Using a computer model, the researchers estimated that the number of oncologists needed to meet the demand for chemotherapy would rise from 65,000 in 2018 to 100,000 in 2040.

The researchers did not respond to a request for comment but did supply a press statement.

“The rising global cancer burden is undoubtedly one of the major health crises of today,” the study’s lead author, Brooke Wilson, a researcher with the University of New South Wales and the Collaboration for Cancer Outcomes, Research and Evaluation at the Ingham Institute for Applied Medical Research, said in the statement. “Strategies are urgently needed to equip the global health workforce to enable safe treatment of current and future patients. Countries and institutions should use our data to estimate their future cancer physician workforce requirements and chemotherapy needs and plan national, regional and global strategies to ensure all those who need it will have access to chemotherapy treatment.”

To calculate the proportion of patients with newly diagnosed cancers who would benefit from chemotherapy, Wilson and her colleagues used best-practice guidelines, patient characteristics and cancer stage data from the U.S. and Australia. They applied those data to the global estimates of adult and pediatric cancers from 2018 through 2014 to get a sense of how many specialists would be needed.

Of the more than 15 million people estimated to require chemotherapy in 2040, 5.2 million, or 35 percent, would be living in eastern Asia, the researchers predicted. Another 1.7 million, or 12 percent, would be residing in south central Asia; 1.4 million, or 10 percent, in North America; 980,646, or seven percent, in southeast Asia; 922,452, or six percent, in South America; and 810,084, or five percent, in western Europe.

The most common indications for chemotherapy worldwide in 2040 are predicted to be lung cancer, breast cancer, and colorectal cancer, Wilson and her colleagues noted.

While the new study has some limitations, it is a call to action, said Dr. William Nelson, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medicine in Baltimore, Maryland.

“Most alarming are the numbers of people who will require chemotherapy. That’s expected to rise from 9.8 million to 15 million,” Nelson said.

There are a number of reasons for the big increases that are predicted in cancer diagnoses, Nelson said. Chief among them is the fact that people will be living longer, which means more will end up developing cancer, he added.

“Age is one of the major drivers,” Nelson said. “Something like 80 percent of cancers in this country arise in people above the age of 60.”

The new paper is making the case for “better strategic thinking around this,” Nelson said.

One possible solution is to have an oncologist managing treatment plans with other personnel carrying out the details, Nelson said.

It’s also possible that therapies for cancer will have changed by 2040. “A lot of chemotherapy is done by infusions,” Nelson explained. “Some of the newer ones are pills that people can take with a little less in the way of hazardous side effects.”

SOURCE: The Lancet Oncology, online May 8, 2019.