From the Division of Gynecologic Oncology, the Division of Clinical and Epidemiological Research, and the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
Obstet Gynecol. 2010 Dec;116(6):1366-1372. doi: 10.1097/AOG.0b013e3181fc3a22.
To estimate the ratio of gynecologic cancer cases to practicing gynecologic oncologists in the United States over the next 40 years.
Using population projections from the U.S. Census Bureau and incidence and mortality rates from Surveillance, Epidemiology and End Results surveys, we estimated the annual number of new gynecologic cancer cases through 2050; the effects of human papillomavirus (HPV) vaccination was included in cervical cancer estimates. The number of practicing gynecologic oncologists was projected through 2050 using data from the 2005 Society of Gynecologic Oncologists Practice Survey, current Society of Gynecologic Oncologists membership information, American Board of Obstetrics and Gynecology and Gynecologic Oncology oral examination results, and mortality estimates from U.S. life tables. Projected time in practice was sex-dependent based on Society of Gynecologic Oncologists Practice Survey. For sensitivity analyses, we varied annual number and sex distribution of fellowship graduates, HPV vaccination coverage rates, and future incidence of overweight and obesity.
At constant training rates, the annual number of new cancer cases per practicing gynecologic oncologist will rise from 112 in 2010 to 133 in 2050, a 19% increase. If the annual number of fellowship graduates increases by 25%, the ratio of cancer cases per gynecologic oncologist will decrease to 106, a 5% decrease. Projections are more sensitive to changes in physician demographics than to changes in HPV vaccination coverage rates.
The gynecologic cancer caseload of practicing gynecologic oncologists will increase by almost 20% over the next 40 years at constant training rates. Changes in the projected sex distribution of fellowship graduates and their time in practice affect these projections.
估计未来 40 年内美国妇科肿瘤学家诊治的妇科癌症病例比例。
利用美国人口普查局的人口预测数据和监测、流行病学和最终结果调查的发病率和死亡率数据，我们估算了 2050 年前每年新发妇科癌症病例数；宫颈癌估计数中包括人乳头瘤病毒（HPV）疫苗的影响。通过 2005 年妇科肿瘤学家协会实践调查、当前妇科肿瘤学家协会会员信息、美国妇产科委员会和妇科肿瘤学口头考试结果以及美国生命表的死亡率估计数据，预测了 2050 年前的执业妇科肿瘤学家人数。根据妇科肿瘤学家协会实践调查，预测的执业时间取决于性别。为了敏感性分析，我们改变了每年 fellowship 毕业生人数和性别分布、HPV 疫苗接种覆盖率以及超重和肥胖未来发病率。
在培训率不变的情况下，每 1 名执业妇科肿瘤学家诊治的新癌症病例数将从 2010 年的 112 例增加到 2050 年的 133 例，增长 19%。如果每年 fellowship 毕业生人数增加 25%，那么每位妇科肿瘤学家诊治的癌症病例数将降至 106 例，下降 5%。预测结果对医生人口统计学的变化比 HPV 疫苗接种覆盖率的变化更为敏感。
在培训率不变的情况下，未来 40 年内，执业妇科肿瘤学家诊治的妇科癌症病例数将增加近 20%。 fellowship 毕业生预计性别分布及其执业时间的变化会影响这些预测。
