Supply and Demand for Radiation Oncology in the United States: Updated Projections for 2015 to 2025

Abstract

Prior studies forecast demand for radiation therapy to grow 10 times faster than supply between 2010 and 2020. We updated these projections for 2015 to 2025 to determine whether this imbalance persists and to assess the accuracy of prior projections. Demand for radiation therapy between 2015 and 2025 was estimated by combining current radiation utilization rates determined by Surveillance, Epidemiology, and End Results data with population projections provided by the Census Bureau. Supply of radiation oncologists was forecast using workforce demographics and full-time equivalent (FTE) status provided by the American Society for Radiation Oncology (ASTRO), current resident class sizes, and expected survival per life tables from the Center for Disease Control. Between 2015 and 2025, the annual total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 19%, from 490,000 to 580,000. Assuming a graduating resident class size of 200, the number of FTE physicians is expected to increase by 27%, from 3,903 to 4,965. Compared to prior projections, the new projected demand for radiation therapy in 2020 dropped by 24,000 cases (a 4% relative decline). This decrease is attributable to an overall reduction in the utilization of radiation to treat cancer, from 28% of all newly diagnosed cancers in the prior projections down to 26% for the new projections. In contrast, the new projected supply of radiation oncologists in 2020 increased by 275 FTEs compared to the prior projection for 2020 (a 7% relative increase), attributable to rising residency class sizes. The supply of radiation oncologists is expected to grow more quickly than demand for radiation therapy from 2015 to 2025. Further research is needed to determine whether this is an appropriate correction or will result in excess capacity.