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. 2025 Jun 1;197(21):E590-E596.
doi: 10.1503/cmaj.241425.

Advances in cancer therapy require urgent changes to the oncology workforce

Omar Abdel-Rahman  1 , Ethan McFarlane  1 , Hyejee Ohm  1 , Angela Chan  1 , Shaun Loewen  1 , Ariane Litalien  1 , Helen Steed  1 , John Walker  2
Affiliations

Advances in cancer therapy require urgent changes to the oncology workforce

Omar Abdel-Rahman et al. CMAJ. .
No abstract available

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Conflict of interest statement

Competing interests:: Omar Abdel-Rahman reports honoraria from Bayer and consulting fees from Ipsen, Eli Lilly, Roche, Bayer, Amgen, and Eisai. Angela Chan reports honoraria from Astra-Zeneca, Daichii, Sankyo, Eisai, Gilead, Merck, Novartis, and Pfizer and advisory board participation with AstraZeneca, Bristol Myers Squibb, Eli Lilly, Gilead, Merck, Novartis, Pfizer, and Roche. Shaun Loewen is a board member with the Canadian Association of Radiation Oncology. Ariane Litalien reports funding from the Canadian Foundation for Women’s Health, Alberta Women’s Health Foundation, and Women and Children’s Health Research Institute, as well as travel support from the University of Alberta, the American College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynaecologists of Canada. Dr. Litalien chairs and sits on working groups with the Society of Obstetricians and Gynaecologists of Canada. John Walker reports honoraria from Bristol Myers Squibb, Merck, Pfizer, Regeneron, Immunocore, Novartis, Sanofi-Aventis, and Incyte. Dr. Walker sits on advisory boards with Oncology Education and the Canadian Agency for Drugs and Technologies in Health.

Figures

Figure 1:
Figure 1:
Cumulative Health Canada–approved immunotherapy treatment indications. Health Canada–approved immunotherapy treatment indications are presented relative to the year of publication of the registration clinical trial. Each block represents a distinct treatment indication, with tumour histology indicated, where applicable. Colour and pattern of blocks represent pharmaceutical agents, as shown by legend. See Related Content tab for accessible version. Note: CRC = colorectal cancer, CuSCC = cutaneous squamous cell carcinoma, ES-SCLC = extensive-stage small cell lung cancer, HCC = hepatocellular carcinoma, MSI = micro-satellite instability, NSCLC = non–small cell lung cancer, RCC = renal cell carcinoma, SCC = squamous cell carcinoma, TNBC = triple-negative breast cancer, UC = urothelial carcinoma.
Figure 2:
Figure 2:
(A) Increase in annual oncology visits for immunotherapy and targeted therapy among patients with early-stage non–small cell lung cancer (NSCLC). We estimated care needs (reported in number of visits per province and nationally) based on the prevalence of the ALK and EGFR mutations (around 5% and 15% of all NSCLC patients, respectively). Patients with these mutations receive adjuvant targeted therapy, while the remainder of patients are eligible for immunotherapy. (B) Compared with pre-2023, each patient now requires an estimated 16–26 additional assessments. To estimate the number of treatment-eligible patients, we used the predicted incidence of NSCLC in Canada, and divided the incidence by 3 to reflect the proportion of patients who present with resectable disease. We calculated the number of additional oncologists required per province by dividing the total number of new assessments by 2530 (assuming medical oncologists work 5–6 clinics per week, seeing 10 patients per clinic, for 46 weeks per year). See Related Content tab for accessible version. Note: chemo = chemotherapy, IO = immunotherapy, TKI = tyrosine-kinase inhibitor.
Figure 3:
Figure 3:
Number of (A) medical and (B) radiation oncologists per 100 000 population, nationally and by province between 2005 and 2023.
Figure 4:
Figure 4:
(A) Proportional change in number and age of the population in Canada (2001–2018), including the median age of the total population and the proportion of Canadians older than 50 years. (B) Proportional change in population, cancer incidence, and cancer prevalence in Canada (2001–2018). All data are reported as proportional change relative to 2001. Data source: Statistics Canada.,
See this image and copyright information in PMC

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