A study published in The Lancet Oncology found that between 2018 and 2040, the number of patients requiring chemotherapy annually will increase from 9.8 million to 15.0 million, a relative increase of 53%.
Researchers used data from GLOBOCAN 2018, developed by the International Agency for Research on Cancer, to identify 29 types of cancer in 183 countries in 2018 and project the incidence in 2040. The most common indications for chemotherapy are lung cancer (16.4%), breast cancer (12.7%), and colorectal cancer (11.1%).
Researchers used evidence-based guidelines to determine optimal chemotherapy use and then estimated the corresponding oncologist workforce required to deliver this chemotherapy on the basis of physicians seeing 150 new patients requiring chemotherapy per year.
Fifteen Million Patients Will Need First-Course Chemo in 2040 – https://t.co/sdxEFMUhQe
— Mazen M. Salama MD (@MazenSalama) May 12, 2019
Growing need for chemotherapy
In 2018, 57% of patients with cancer worldwide required first-line chemotherapy, and by 2040, the number of new cases of cancer is projected to be 26 million, an estimated 15 million of which will require chemotherapy.
The estimated proportion of patients needing chemotherapy who reside in low- or middle-income countries was 63% (n=6,162,240/9,782,783) in 2018. This will reach 67% (n=10,071,049/14,984560) by 2040. The researchers found that the largest proportion of patients who will need chemotherapy in 2040 will be residing in upper-middle-income countries, making it more challenging for low- and middle-income countries to meet the increasing demand for chemotherapy.
The greatest proportional growth in the need for chemotherapy during this time is projected to occur in eastern Africa (115% increase), middle Africa (114%), western Africa (100%), and western Asia (99%). However, the highest demand for chemotherapy in 2040 will be in China, which will account for more than one-quarter of all global chemotherapy needs.
Will there by enough oncologists?
The researchers estimated that in 2018, 65,000 oncologists were required worldwide to deliver optimal chemotherapy and that will rise to 100,000 by 2040. The researchers believe that there will be a physician shortage in all countries, regardless of economic status. In addition, this model only accounts for first-line chemotherapy needs and does not include second-line and subsequent chemotherapy.
“Strategic investments in chemotherapy service provision and cancer physicians are needed to meet the projected increased demand for chemotherapy in 2040,” the researchers concluded. “The rising cancer burden and the increasing demands for chemotherapy globally will be major health crises during the next 20 years.”