Projecting 2050 oncology workforce through historical regional trends and economic stratification.

Abstract

9004 Background: Global oncology workforce planning increasingly relies on predictive modeling to guide policy and investment. However, projections are highly sensitive to baseline stratification. Historical models often use broad geographic regions, which may obscure economic heterogeneity within regions. We analyzed historical workforce trends and compared regional versus income-stratified projection models to quantify how perceptions of the 2050 oncology workforce burden have evolved. Methods: We extracted oncology workforce data from peer-reviewed literature, government and ministry of health reports, and datasets from professional organizations, including ESMO and ASCO. Cancer incidence and population projections were obtained from GLOBOCAN and UN sources. Workforce burden was defined as annual new cancer cases per clinical oncologist. Historical burden velocity was estimated using comparative data from 2012–2018 and applied to current scenario to build projections. Two models were evaluated: a regional model based on geographic trends and an economic model stratified by World Bank income groups. Results: Retrospective analysis (2012–2018) demonstrated substantial regional divergence. Europe showed relative stability, with workforce burden improving by –0.6% per year, while appearing comparable to Asia in 2018 (275 vs. 248 cases per oncologist). However, Asia’s burden increased by +8.6% per year, indicating incidence growth already outpacing workforce expansion despite similar cross-sectional values. Using regional trends, the projected 2050 burden reached 694 cases per oncologist for Africa and 3,499 for Asia. In contrast, income-based stratification revealed a markedly steeper trajectory for the most vulnerable economies. At baseline, high-income countries (HICs) had 30,400 oncologists, upper-middle-income countries (UMICs) 46,140, lower-middle-income countries (LMICs) 6,370, and low-income countries (LICs) only 70 providers combined. Projected through historic trends, 2050 burden reached approximately 295 cases per oncologist in HICs, 1,450 in LMICs, and ~11,500 in LICs. This represents a 16-fold increase when shifting from regional (Africa: 694) to economic (LIC: 11,500) projections, while also revealing lower-than-expected burden in emerging economies . Conclusions: Comparing regional and income-stratified projections reveals a profound predictive divergence. Although there is limited workforce data for higher accuracy projections, geographic averaging masks extreme workforce deficits in low-income countries while overstating burden in middle-income settings. Absolute workforce growth alone is insufficient to assess preparedness. Future oncology workforce planning should prioritize income-based stratification to accurately identify and address the most critical global capacity gaps.