A new modelling study led by UNSW and published in The Lancet Oncology predicts demand for cancer surgery will rise by 52 per cent over the next two decades.
The study was an international collaboration between researchers from UNSW Sydney, University of Toronto, Kings College London, and the World Health Organization.
According to the study, the number of cancer cases requiring surgery globally each year will rise from 9.1 million to 13.8 million between 2018 to 2040 – an increase of 52 per cent or 4.7 million cases.
The research shows the greatest relative increase will occur in 34 low-income countries, where the number of cases requiring surgery is expected to more than double by 2040 (314,355 cases to 650,164).
Lead author Dr Sathira Perera, a UNSW Scientia PhD scholar, said the absence of evidence-based estimates of future demand had restricted efforts to improve cancer care around the world.
“Our analysis has revealed that, in relative terms, low-income countries will bear the brunt of increased future demand for cancer surgery, bringing with it a need to substantially increase numbers of surgeons and anaesthetists,” said Dr Perera.
“These findings highlight a need to act quickly to ensure that increasing workforce requirements in low-income countries are adequately planned for. There needs to be an increased focus on the application of cost-effective models of care, along with government endorsement of scientific evidence to mobilise resources for expanding services.
“In addition, access to post-operative care is strongly linked to lower mortality – so, improving care systems globally must be a priority in order to reduce the disproportionate number of deaths following complications.”
The researchers extended their predictions to the predicted requirements for surgical and anaesthesia workforces. They compared the optimal estimated workforce (the median workforce of 44 high-income countries) with the number of surgeons and anaesthetists in each country.
Dr Perera said there was a current global shortage of 199,000 surgeons and 87,000 anaesthetists.
“This is based on the current workforce of 766,000 surgeons and 372,000 anaesthetists, compared with 965,000 and 459,000 needed for an optimal workforce, respectively, in our modelling study,” he said.
“The gap is estimated to be greatest in low-income countries, where the current surgeon availability is 22,000 fewer than the model estimated optimal number of 28,000 surgeons.
“The current number of anaesthetists in low-income countries falls 11,000 below the model estimated demand of 13,000 anaesthetists.”
By 2040, and taking account of the predicted future cancer incidence burden in each country, the surgical workforce will need to increase from 965,000 in 2018 to 1.416 million in 2040 (a 47 per cent increase). The anaesthetist workforce would need to rise from 459,000 in 2018 to 674,000 in 2040 (a 47 per cent increase).
Dr Perera added, “But to match the current benchmark of high-income countries, the actual number of surgeons in low-income countries would need to increase almost 400 per cent (from 6,000 to 28,000), and anaesthetists by almost 550 per cent (from 2000 to 13,000), of their baseline values.
“This is because the current workforce in low-income countries is already substantially smaller than in high-income countries.”