Department of Radiation Oncology, Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Clinical Research Center for Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.
Division of Radiation Oncology and Precision Radiotherapeutics and Oncology Programme, Division of Medical Sciences, National Cancer Centre Singapore, Singapore; Medical School, Duke-National University of Singapore, Singapore.
Lancet Glob Health. 2024 Dec;12(12):e1945-e1953. doi: 10.1016/S2214-109X(24)00355-3. Epub 2024 Oct 11.
Addressing the challenge of cancer control requires a comprehensive, integrated, and global health-system response. We aimed to estimate global radiotherapy demands and requirements for radiotherapy professionals from 2022 to 2050.
We conducted a population-based study using data from the Global Cancer Observatory (GLOBOCAN) 2022 and predicted global radiotherapy demands and workforce requirements in 2050. We obtained incidence figures for 29 types of cancer across 183 countries and derived the cancer-specific radiotherapy use rate using the 2013 Collaboration for Cancer Outcomes Research and Evaluation model. We delineated the proportion of people with cancer who require radiotherapy and can be accommodated within the existing installed capacity, assuming an optimal use rate of 50% or 64%, in both 2022 and 2050. A use rate of 50% corresponds to the global average and a use rate of 64% considers potential re-treatment scenarios, as indicated by the 2013 Collaboration for Cancer Outcomes Research and Evaluation (CCORE) radiotherapy use rate model. We established specified requirements for teletherapy units at a ratio of 1:450 patients, for radiation oncologists at a ratio of 1:250 patients, for medical physicists at a ratio of 1:450 patients, and for radiation therapists at a ratio of 1:150 patients in all countries and consistently using these ratios. We collected current country-level data on the radiotherapy-professional workforce from national health reports, oncology societies, or other authorities from 32 countries.
In 2022, there were an estimated 20·0 million new cancer diagnoses, with approximately 10·0 million new patients needing radiotherapy at an estimated use rate of 50% and 12·8 million at an estimated use rate of 64%. In 2050, GLOBOCAN 2022 data indicated 33·1 million new cancer diagnoses, with 16·5 million new patients needing radiotherapy at an estimated use rate of 50% and 21·2 million at an estimated use rate of 64%. These findings indicate an absolute increase of 8·4 million individuals requiring radiotherapy from 2022 to 2050 at an estimated use rate of 64%; at an estimated use rate of 50%, the absolute increase would be 6·5 million individuals. Asia was estimated to have the highest radiotherapy demand in 2050 (11 119 478 [52·6%] of 21 161 603 people with cancer), followed by Europe (3 564 316 [16·8%]), North America (2 546 826 [12·0%]), Latin America and the Caribbean (1 837 608 [8·7%]), Africa (1 799 348 [8·5%]), and Oceania (294 026 [1·4%]). We estimated that the global radiotherapy workforce in 2022 needed 51 111 radiation oncologists, 28 395 medical physicists, and 85 184 radiation therapists and 84 646 radiation oncologists, 47 026 medical physicists, and 141 077 radiation therapists in 2050. We estimated that the largest proportion of the radiotherapy workforce in 2050 would be in upper-middle-income countries (101 912 [38·8%] of 262 624 global radiotherapy professionals).
Urgent strategies are required to empower the global health-care workforce and facilitate the fundamental human right of access to suitable health care. A collective effort with innovative and cost-contained health-care strategies from all stakeholders is warranted to enhance global accessibility to radiotherapy and address challenges in cancer care.
China Medical Board Global Health Leadership Development Program, Shanghai Science and Technology Committee Fund, China Ministry of Science and Technology Department of International Cooperation High Level Cooperation and Exchange Projects, and Fudan University Office of Global Partnerships Key Projects Development Fund.
For the Arabic, Chinese, French, Russian and Spanish translations of the summary see Supplementary Materials section.
应对癌症控制的挑战需要全面、综合和全球卫生系统的响应。我们旨在估计全球放疗需求和 2050 年放疗专业人员的需求。
我们使用全球癌症观测站(GLOBOCAN)2022 年的数据进行了一项基于人群的研究,并预测了 2050 年全球放疗需求和劳动力需求。我们获得了 183 个国家 29 种癌症的发病率数据,并使用 2013 年癌症结局研究与评估合作(CCORE)模型得出了特定癌症放疗使用率。我们划定了需要放疗的癌症患者比例,并在假设使用 50%或 64%的最佳使用率的情况下,分别在 2022 年和 2050 年将这些患者纳入现有的安装容量。50%的使用率对应全球平均水平,而 64%的使用率考虑了 2013 年 CCORE 放疗使用率模型所表示的潜在再治疗情况。我们为远程治疗单位、肿瘤学家、医学物理学家和放射治疗师分别建立了特定的要求,比例为每 450 名患者 1 个单位、每 250 名患者 1 名肿瘤学家、每 450 名患者 1 名医学物理学家和每 150 名患者 1 名放射治疗师,并且在所有国家都始终使用这些比例。我们从 32 个国家的国家卫生报告、肿瘤学会或其他当局收集了当前国家一级的放疗专业人员劳动力数据。
2022 年,预计有 2000 万例新癌症诊断,其中约 1000 万例新患者预计使用 50%的使用率需要放疗,预计使用 64%的使用率需要放疗 1280 万例。到 2050 年,GLOBOCAN 2022 年的数据显示,预计将有 3310 万例新癌症诊断,预计使用 50%的使用率需要放疗的新患者为 1650 万例,预计使用 64%的使用率需要放疗的新患者为 2120 万例。这些发现表明,到 2050 年,预计将有 840 万人需要放疗,比 2022 年增加 64%;如果按照 50%的使用率计算,绝对增加人数将为 650 万。亚洲预计将在 2050 年拥有最高的放疗需求(2116.1603 名癌症患者中的 11119478 名[52.6%]),其次是欧洲(3564316 名[16.8%])、北美(2546826 名[12.0%])、拉丁美洲和加勒比地区(1837608 名[8.7%])、非洲(1799348 名[8.5%])和大洋洲(294026 名[1.4%])。我们估计,2022 年全球放疗劳动力需要 51111 名肿瘤学家、28395 名医学物理学家和 85184 名放射治疗师,2050 年需要 84646 名肿瘤学家、47026 名医学物理学家和 141077 名放射治疗师。我们估计,2050 年放疗劳动力中最大的比例将来自中高收入国家(全球 262624 名放疗专业人员中的 101912 名[38.8%])。
需要采取紧急战略来增强全球卫生保健劳动力,并促进获得适当保健的基本人权。所有利益攸关方都需要共同努力,制定创新和具有成本效益的卫生保健战略,以增强全球获得放疗的机会,并解决癌症护理方面的挑战。
中国医学基金会全球卫生领导力发展计划、上海市科学技术委员会基金、中国科技部国际合作高水平合作与交流项目、复旦大学全球伙伴关系办公室重点项目发展基金。