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Oncology Workforce Shortages Affect Regions with Highest Cancer Burden and Mortality

The collaborative study shows significant gaps in low- and middle-income countries
26 Nov 2021

LUGANO, Switzerland – ESMO welcomes the recently published research characterising the availability of cancer care professionals to national populations around the world, featured in ESMO Open Cancer Horizons. (1)

“The insights offered into the distribution of the workforce involved in cancer care come at just the right time,” says ESMO President Prof. Solange Peters, highlighting that the paper is a product of ESMO’s collaboration on a WHO project aiming to optimise the use of professional competencies required to deliver cancer care in countries globally and to plan for future needs.

Based on a literature review, the analysis has revealed deep disparities in the presence of skilled health workers between low-middle and high-income countries. The ESMO President notes that this is the first systematic review contrasting the numbers of cancer care professionals working in individual countries with the size of the populations and the number of cancer patients they serve. “Although national and international data available for such comparisons were limited, stark inequalities became evident as high-income countries overall reported ratios of oncology professionals to cancer patients within the optimal range to meet health system needs, while in low- and middle-income countries (LMICs) shortages were documented across professional categories,” she underlines.

Cancer care today relies on the intervention of multiple skilled healthcare providers, from anatomic pathologists, through medical and paediatric oncologists, surgeons and oncology nurses all the way to radiation oncologists and technicians. Together, this oncology workforce is key to delivering multidisciplinary care and its unavailability or inaccessibility is widely recognised as having dire consequences for patient outcomes and population health. (2)

“As oncologists, we are all too aware of the risks associated with the continuing Covid-19 pandemic, including that of losing already scarce cancer care resources as a result of funds being reallocated to communicable disease management or of funds being cut in the course of the financial crisis many countries are facing,” Peters continues.

In a context where LMICs shoulder most of the cancer burden and suffer the highest cancer mortality, these findings can inform policymaking and modelling for capacity-building across health systems that have diverse definitions and qualification requirements for oncology professions and that experience difficulties retaining skilled workers.

“Committed to supporting the development and training of the oncology workforce, but also its wellbeing and resilience in difficult times, at ESMO we are aware of our important role as a member-based society and are pleased to have the opportunity to provide technical expertise to the WHO on global issues in this field. A big thanks to the authors of the paper for their professional contributions to this ongoing effort to build and strengthen the cancer workforce,” Peters concludes.


  1. D. Trapani, S.S. Murphy, M. Boniol, C. Booth, V.C. Simensen, M.K. Kasumba, R. Giuliani, G. Curigliano and A.M. Ilbawi. Distribution of the workforce involved in cancer care: a systematic review of the literature. doi.org/10.1016/j.esmoop.2021.100292
  2. R. Atun, D.A. Jaffray, M.B. Barton, F. Bray, M. Baumann, B. Vikram, T.P. Hanna, F.M. Knaul, Y. Lievens, T.Y.M. Lui, M. Milosevic, B. O’Sullivan, D.L. Rodin, E. Rosenblatt, J. Van Dyk, M.L. Yap, E. Zubizarreta and M. Gospodarowicz. Expanding global access to radiotherapy. doi.org/10.1016/S1470-2045(15)00222-3

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