Too much of a good thing? Projecting the need for gynecologic oncologists over the next 20 years

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Gynecologic oncology Pub Date : 2024-11-02 DOI:10.1016/j.ygyno.2024.10.027
Teresa K.L. Boitano , Stephanie V. Blank , Laura J. Havrilesky , Warner K. Huh , Evan R. Myers
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Abstract

Objective

To estimate the effect of growth in gynecologic oncology fellowships in the United States on surgical volume for trainees and practicing gynecologic oncologists over the next 20 years.

Methods

Using 2010–2019 age-specific gynecologic cancer incidence estimates from US Cancer Statistics, significant changes in incidence were identified with Joinpoint software. Statistically significant changes in annual rates were projected forward five years, and these estimates were used to generate projections of cancer cases in the population from the U.S. The number of practicing gynecologic oncologists was projected through 2045 based on current fellowship enrollment. For sensitivity analysis, we varied the number of new fellows and fellowships based on data trends from the last five years.

Results

Over the next 20 years, cancer cases will increase by 14 % with the majority being endometrial. With current trainee numbers, the average annual number of new surgical cancer patients per practicing gynecologic oncologist will decrease from 73 to 51 (30 % decrease). An increase of one fellow per year nationally to the total number of trainees will further decrease new surgical cancer cases to 43 cases/gynecologic oncologist annually (41 % decrease). When accounting for one additionally trainee nationally per year over the next 20 years, the average number of oncologic surgical cases per fellow/year will decrease from 208 to 160 (23 % decrease). Under the assumption of no additional fellowship positions, surgical cases will increase from 208 to 226 per fellow/year (9 % increase).

Conclusion

The gynecologic cancer caseload of practicing gynecologic oncologists is estimated to decrease by nearly 41 % and trainee case volume will drop by 23 % over the next 20 years with minimal continued addition of training positions. Careful consideration should be given to creating an appropriate balance between the number of practicing gynecologic oncologists, potential dilution of programs' case volume per trainee, and the effects on the needs of future patients.
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好事太多?预测未来 20 年对妇科肿瘤专家的需求。
目的估算未来 20 年美国妇科肿瘤研究金的增长对受训者和执业妇科肿瘤专家手术量的影响:方法: 利用美国癌症统计局提供的 2010-2019 年特定年龄妇科癌症发病率估计值,使用 Joinpoint 软件确定发病率的显著变化。根据目前的研究员注册情况,预测了到 2045 年的妇科肿瘤执业医师人数。在敏感性分析中,我们根据过去五年的数据趋势改变了新研究员和研究员的数量:未来 20 年,癌症病例将增加 14%,其中大部分是子宫内膜癌。按照目前的受训人数计算,每名执业妇科肿瘤学家每年新增的癌症手术患者平均人数将从 73 人减少到 51 人(减少 30%)。如果全国的受训人员总数每年增加一名研究员,那么每名妇科肿瘤学家每年新增的外科癌症病例将进一步减少到 43 例(减少 41%)。如果在未来 20 年内全国每年增加一名受训人员,则每位研究员每年的肿瘤外科病例数将从 208 例减少到 160 例(减少 23%)。在不增加研究员职位的假设下,每位研究员每年的手术病例数将从 208 例增加到 226 例(增加 9%):据估计,在未来 20 年内,妇科肿瘤执业医师的妇科癌症病例量将减少近 41%,而受训人员的病例量将减少 23%,而继续增加培训职位的可能性微乎其微。应慎重考虑如何在执业妇科肿瘤学家的数量、每个受训者的病例量可能被稀释的情况以及对未来患者需求的影响之间建立适当的平衡。
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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