Analysis of nationwide lung, breast, and prostate cancer incidence in relation to provider availability and training programs in oncology.

Abstract

e13116 Background: Lung, Breast, and Prostate cancer are the leading causes of cancer incidences and mortality across all ages, races, and genders. These accumulate to 1.2 million deaths from 2011-2015. We hypothesize that the regional provider availability should match the local patterns of cancer incidences due to resource scarcity. This analysis examines the nationwide incidence of the most common cancers in relation to provider availability and conducts a further analysis of the location of training programs in relation to cancer incidence. Methods: Lung, Breast, and Prostate cancer incidences in the U.S. between ages 19-85 was assessed using data from the CDC and NCI. Oncology fellowships were found through the ERAS portal and the databases of the AMA. Oncologists’ practicing locations were found using Doximity data. These datasets were mapped using Google Maps software and a gap analysis was conducted. Results: In 2015, approximately 6.2% of the population were diagnosed with lung cancer, 12.4% of women with breast cancer, and 11.2% of men with prostate cancer. The highest incidences were seen in Kentucky, Connecticut, and New Jersey. Above average incidences were seen in New Hampshire, West Virginia, Mississippi, Louisiana, and Massachusetts. Roughly 25% of the 16,215 registered oncologists were concentrated in Florida, Texas, and California. A total of 132 oncology fellowships were identified, with only eight located within a 50-mile radius of the areas of most need. Conclusions: We found a significant disparity in the distribution of cancer incidences versus location in oncologists and fellowship programs. This data, along with data from the 2018 National Oncologists Workforce suggests that Florida, California, Michigan, Illinois, and New York have the highest percentage of oncologists near or above retirement age; indicating that the gap is likely to widen. It also showed a 12-fold variation in oncologist retention compared to where they completed their fellowship, with metropolitan areas in California rounding out the top 10 highest percentages of trained oncologists1. This highlights the need to match the workforce with areas of highest need, such as the Appalachian states; which have some of the highest cancer incidences and largest discrepancies of training programs and oncologists.