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Int. J. Radiat. Oncol. Biol. Phys. · Sep 2019
National Trends and Dynamic Responses in the Canadian Radiation Oncology Workforce From 1990 to 2018.
- Shaun K Loewen, Corinne M Doll, Ross Halperin, Matthew Parliament, Robert G Pearcey, Michael F Milosevic, Andrea Bezjak, Eric Vigneault, and Michael Brundage.
- Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Canada. Electronic address: shaun.loewen@albertahealthservices.ca.
- Int. J. Radiat. Oncol. Biol. Phys. 2019 Sep 1; 105 (1): 31-41.
PurposeTo report radiation oncology (RO) workforce and cancer incidence trends in Canada and explore the relationship between the two.Methods And MaterialsCanadian radiation oncologist, trainee, and cancer incidence data from 1990 to 2018 were collected from the following publicly accessible administrative and health information databases: Canadian Post-MD Education Registry (1990-2018), Canadian Medical Association Physician Data Centre (1994-2018), Canadian Institute for Health Information/Scott's Medical Database (1990-2017), Canadian Cancer Registry (1990-2017), and Statistics Canada (1990-2017). Descriptive statistics were used to summarize the data.ResultsThe Canadian RO workforce grew from 240 radiation oncologists in 1990 to 567 in 2018, with the largest growth period from 2005 to 2015 adding 207 radiation oncologists. Regional analyses revealed steady or stepwise growth in all Canadian regions, except in Québec, where the number of radiation oncologists decreased from 86 in 1990 to 57 in 2003 before rising to 139 by 2018. Trainee totals were between 54 and 173 per year with 2 periods of growth (1990-1996 and 2001-2008) and regression (1996-2001 and 2008-2018), signifying trainee supply variability. Female proportions of the workforce and trainees, respectively, rose steadily from 18% to 38% and 28% to 50%, while the workforce proportion with non-Canadian medical degrees decreased from 40% to 26%. Radiation oncologists younger than 40 years increased from 70 to 171, whereas those age 60 years and older decreased from 85 in 1990 to 31 in 2002 and then increased to 108 in 2017. Annual cancer incidence rose steadily from 103,780 to 206,290 cases/year. The annual cancer incidence-to-provider ratio fluctuated (364-475:1) and trended lower with time, and proportional cancer incidence-to-provider ratios varied between 0.7:1 and 1.6:1 in Canada's regions before approaching 1:1.ConclusionsOur study demonstrates the challenges and successes of managing the Canadian radiation oncologist workforce. These data will inform policy makers and other stakeholders to ensure that the profession meets the current and future needs of Canadian cancer patients.Copyright © 2019 Elsevier Inc. All rights reserved.
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