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U.S. could face a shortage of cancer doctors, study says
Future demand for oncologists expected The United States faces a serious shortage of cancer doctors in coming years as the population ages and advances in medicine increase the number of people living with the disease, according to a new study.
The study, published online Tuesday in the Journal of Oncology Practice, projects a 55 percent increase in the demand for cancer treatment by 2020 but only a 14 percent increase in the time doctors have available to see patients. That translates to a shortfall of as many as 4,080 cancer specialists, or oncologists.
"This is a looming crisis," said Edward Salsberg, director of the Association of American Medical Colleges' Center for Workforce Studies, which conducted the study.
"If action isn't taken, we'll face a major challenge ensuring all patients receive timely care," Salsberg said. "We may have to (prioritize) those patients who need most urgent care."
To cope with the increased burden, the report's authors suggest nurse practitioners, physician assistants and hospices pick up some of the workload; primary-care doctors monitor patients who've finished treatment for recurrence; older oncologists delay retirement; more cancer specialists be trained; and technological advances, such as electronic medical records, be employed to free up more of doctors' time for patient care.
Salsberg said he thinks rural areas, many of which already suffer from a shortage of oncologists, will be hit harder than urban areas. Academic centers that train cancer doctors, like Houston, likely will do better than outlying areas, he said.
Support for findings
Nevertheless, officials at the University of Texas M.D. Anderson Cancer Center and Baylor College of Medicine's Dan L. Duncan Cancer Center, Houston's two main oncology programs, expressed concern about the trend.
"The first thing I'd say, based on what we're seeing here is, the study looks on target," said Dr. Michael Fisch, medical director of the community clinical oncology program at M.D. Anderson. "You can tell by the growth in patient visits in recent years."
In 2004, because of growing waiting times, M.D. Anderson stopped providing second opinions to breast cancer patients who intend to be treated elsewhere. The center is in the midst of a major building expansion to meet expected inpatient demand.
"I think it's going to affect everyone," said Dr. Martha Mims, director of clinical trials at Baylor's Duncan Center. "Two ... programs here helps Houston, but if we're going to look to nurse-practitioners and primary-care physicians to help care for patients, that's going to require training."
About 10,400 oncologists practice in the United States, with roughly 500 new ones entering the work force each year. But more than half of the oncologists practicing are older than 50 and could retire soon, according to the study.
Young doctors are in the pipeline to replace them, but the study suggests they won't be able to keep up with the demand. For instance, training more oncologists is expected to provide only a modest bump because of a limited number of slots in training programs. There is also concern that younger oncologists may not see as many patients because of questionnaire answers indicating they value their free time more than older colleagues.
Meanwhile, the number of Americans diagnosed with cancer will grow from 11.7 million in 2005 to 18.2 million in 2020. Because of the oncologist shortage, that will leave a shortfall of 9.4 million to 15.1 million doctor visits, the study says.
The surge in cancer is twofold, according to the study. The incidence of cancer, which rises rapidly with age, particularly after age 65, will increase by 48 percent by 2020; and the number of people living with it will increase by 81 percent.
Distant doctors
The latter is a tribute to recent advances in cancer treatment, particularly drugs that target tumors at the molecular level, that often turn the disease into a chronic illness. But such treatment is more complex and often requires a team of doctors.
For that reason, study researchers said oncologists increasingly will become team leaders, spending more time directing care and perhaps less in face-to-face encounters with a single patient.
In any event, the study says the shortage of oncologists will emerge gradually between now and 2020. By then, it says, the shortage could amount to 2,550 to 4,080 doctors. At that time, the supply of oncologists is projected to be about 12,500.
"It's going to be a significant problem," said Dr. Ray DuBois, the incoming provost at M.D. Anderson. "There are going to be a lot of patients that need to be taken care of and a shortage of manpower."
Cancer is the second-leading cause of death in the United States, behind heart disease. The American Cancer Society estimates that nearly 1.4 million people will be diagnosed with cancer this year and more than 560,000 will die of the disease.
The study was commissioned by the American Society of Clinical Oncology.
todd.ackerman@chron.com
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U.S. could face a shortage of cancer doctors, study says
研究称美国可能面临肿瘤医生短缺
Future demand for oncologists expected The United States faces a serious shortage of cancer doctors in coming years as the population ages and advances in medicine increase the number of people living with the disease, according to a new study.
一项新研究表明，随着人口老龄化和医学科技进步使得带病存活人数的增加，在未来几年内，对肿瘤医生的需求预期将成为美国即将面临的大问题。
The study, published online Tuesday in the Journal of Oncology Practice, projects a 55 percent increase in the demand for cancer treatment by 2020 but only a 14 percent increase in the time doctors have available to see patients. That translates to a shortfall of as many as 4,080 cancer specialists, or oncologists.
这项周二刊登于《肿瘤学实践杂志》（the Journal of Oncology Practice）网上的研究预测，到2020年，有55%的肿瘤治疗需求的增加，但同期可以诊视病人的医生人数只增加了14%，换算下来，即为缺口高达4080名癌症专家,或肿瘤医生.
"This is a looming crisis," said Edward Salsberg, director of the Association of American Medical Colleges' Center for Workforce Studies, which conducted the study.
"这是一个迫在眉睫的危机, "主持进行这项研究的爱德华•萨斯伯格（Edward Salsberg）说，他是美国医学院校协会劳动力研究中心的理事长。
"If action isn't taken, we'll face a major challenge ensuring all patients receive timely care," Salsberg said. "We may have to (prioritize) those patients who need most urgent care."
"如果不采取行动,我们将面临能否确保所有患者得到及时医治的重大挑战, "萨斯伯格说. "我们可能被迫只能优先给最需要紧急处理的病人服务. "
To cope with the increased burden, the report's authors suggest nurse practitioners, physician assistants and hospices pick up some of the workload; primary-care doctors monitor patients who've finished treatment for recurrence; older oncologists delay retirement; more cancer specialists be trained; and technological advances, such as electronic medical records, be employed to free up more of doctors' time for patient care.
为了应付日益增加的负担,该报告的作者建议从业护士，医师助理和救济院提升部分工作量; 初级保健医生负责已经完成预防肿瘤复发治疗病人的监测; 老的肿瘤专家延迟退休; 更多的癌症专家接受培训; 利用技术进步,例如电子病历来帮医生腾出更多的时间去照顾病人.
Salsberg said he thinks rural areas, many of which already suffer from a shortage of oncologists, will be hit harder than urban areas. Academic centers that train cancer doctors, like Houston, likely will do better than outlying areas, he said.
萨斯伯格说,他认为农村地区,其中不少已经面临肿瘤医生的短缺, 将受到比城市地区更大的打击. 像休士顿这样的学术中心培训癌症医生,显然会做得比边远地区更加好。
Support for findings
Nevertheless, officials at the University of Texas M.D. Anderson Cancer Center and Baylor College of Medicine's Dan L. Duncan Cancer Center, Houston's two main oncology programs, expressed concern about the trend.
支持证据
休斯顿的两个主要癌症机构，德克萨斯大学M.D.安德森癌症中心和贝勒医学院的丹•L•邓肯癌症中心的官员,表达了对这一的趋势担心。
"The first thing I'd say, based on what we're seeing here is, the study looks on target," said Dr. Michael Fisch, medical director of the community clinical oncology program at M.D. Anderson. "You can tell by the growth in patient visits in recent years."
“基于我们在这里看到的情况，我要说的第一条是, 这项研究正中要害，”迈克尔•费希（Michael Fisch）博士，来自M.D.安德森癌症中心社区临床肿瘤服务计划的医务主任说，"你可以从近几年就诊病人的增长看出这个问题来。"
In 2004, because of growing waiting times, M.D. Anderson stopped providing second opinions to breast cancer patients who intend to be treated elsewhere. The center is in the midst of a major building expansion to meet expected inpatient demand.
2004年,由于越来越长的等待时间, 安德森中心停止为有意到别处就诊的乳腺癌患者提供意见参考服务，该中心正在扩大建筑规模来满足预期的住院需求.
"I think it's going to affect everyone," said Dr. Martha Mims, director of clinical trials at Baylor's Duncan Center. "Two ... programs here helps Houston, but if we're going to look to nurse-practitioners and primary-care physicians to help care for patients, that's going to require training."
"我认为这将影响到每个人, "马萨•米姆斯（Martha Mims）博士，贝勒医学院邓肯中心的临床实验主任说，"休斯顿有两个...服务计划，但如果我们想要从业护士和初级保健医生帮助照顾病人, 还得需要进行培训. "
About 10,400 oncologists practice in the United States, with roughly 500 new ones entering the work force each year. But more than half of the oncologists practicing are older than 50 and could retire soon, according to the study.
根据这一研究，在美国现约有10,400名肿瘤医生执业, 每年大约有500名新进劳动力. 但现有超过一半的肿瘤医生年龄超过50岁,不久即将退休.
Young doctors are in the pipeline to replace them, but the study suggests they won't be able to keep up with the demand. For instance, training more oncologists is expected to provide only a modest bump because of a limited number of slots in training programs. There is also concern that younger oncologists may not see as many patients because of questionnaire answers indicating they value their free time more than older colleagues.
年轻的医生在逐渐取代他们, 但研究显示,他们将无法满足需求。举个例子，好比因为培训计划数量有限的投币口，培养出更多的肿瘤专家预计只能有一个微弱的产出。问卷答案还显示另一种担心,年轻的肿瘤医生因为比他们的老同事更珍视自己的空闲时间，因而未必能接待一样多的病人。
Meanwhile, the number of Americans diagnosed with cancer will grow from 11.7 million in 2005 to 18.2 million in 2020. Because of the oncologist shortage, that will leave a shortfall of 9.4 million to 15.1 million doctor visits, the study says.
与此同时，研究提示，美国被诊断罹患癌症的人数将由2005年的1170万增加到2020年的1820万。由于医生短缺，将会有940万到1510万的诊视缺口。
The surge in cancer is twofold, according to the study. The incidence of cancer, which rises rapidly with age, particularly after age 65, will increase by 48 percent by 2020; and the number of people living with it will increase by 81 percent.
癌症的激增是双重的,根据这项研究. 癌症发病率随着年龄增长迅速上升，尤其是在65岁以后, 到2020年将增加48%，带病生存人数将会增加了81%。
Distant doctors
The latter is a tribute to recent advances in cancer treatment, particularly drugs that target tumors at the molecular level, that often turn the disease into a chronic illness. But such treatment is more complex and often requires a team of doctors.
距离越来越远的医生
带病生存数的增加是近期癌症治疗水平提高的结果, 尤其在分子水平上靶向治疗肿瘤的药物,往往把它变为一种慢性疾病. 但这种治疗较为复杂,往往需要一个医疗小组。
For that reason, study researchers said oncologists increasingly will become team leaders, spending more time directing care and perhaps less in face-to-face encounters with a single patient.
因此,研究人员说, 肿瘤专家将更趋于成为团队领导人, 会花更多的时间指导治疗,而减少与单个病人面对面邂逅的机会。
In any event, the study says the shortage of oncologists will emerge gradually between now and 2020. By then, it says, the shortage could amount to 2,550 to 4,080 doctors. At that time, the supply of oncologists is projected to be about 12,500.
但无论如何,研究所说的肿瘤医生短缺将由现在至2020年之间逐渐呈现。届时，缺口可高达2550至4080人，预计共约有12,500医生提供服务。
"It's going to be a significant problem," said Dr. Ray DuBois, the incoming provost at M.D. Anderson. "There are going to be a lot of patients that need to be taken care of and a shortage of manpower."
“这将是一个重大的问题，”安德森中心的新任教务长雷•杜波伊斯（Ray DuBois）博士说:“将会有大量需要照顾的病人和人力资源缺口。”
Cancer is the second-leading cause of death in the United States, behind heart disease. The American Cancer Society estimates that nearly 1.4 million people will be diagnosed with cancer this year and more than 560,000 will die of the disease.
在美国,癌症是仅次于心脏病的第二号杀手. 美国癌症协会估计, 今年将有近1.4万人被诊断患有癌症,超过560,000将死于这种疾病。
The study was commissioned by the American Society of Clinical Oncology.
这项研究是由美国临床肿瘤学协会委托进行的。
编译后 1312字
研究称美国可能面临肿瘤医生短缺
由美国临床肿瘤学协会委托进行的一项新研究表明，随着人口老龄化和医学科技进步使得带病存活人数的增加，在未来几年内，对肿瘤医生的需求预期将成为美国即将面临的大问题。这项刊登于《肿瘤学实践杂志》（the Journal of Oncology Practice）网上的研究预测，到2020年，肿瘤治疗需求将增加55%，但同期可以诊视病人的医生人数只增加了14%，暴露一个高达4080名肿瘤医生的缺口。 "这场危机迫在眉睫，"美国医学院校协会劳动力研究中心的理事长爱德华•萨斯伯格（Edward Salsberg）说，"如不采取行动,我们将面临能否确保所有患者得到及时医治的重大挑战,而且可能被迫只能优先给最需要紧急处理的病人服务。" 为了应对危机,研究者者建议从业护士，医师助理和救济院增加部分工作量; 初级保健医生负责已经完成预防肿瘤复发治疗病人的监测; 老一辈肿瘤专家延迟退休; 更多专业人员接受培训; 充分利用现有的技术进步（例如电子病历）来帮医生腾出更多的时间去照顾病人。萨斯伯格补充道，在农村地区,其中不少已经面临肿瘤医生的短缺, 将受到比城市地区更大的打击，像休斯顿这样的学术中心培训癌症医生,显然会做得比边远地区更加好。
休斯顿的两个主要癌症机构，德克萨斯大学M.D.安德森癌症中心和贝勒医学院的丹•L•邓肯癌症中心的官员,表达了对这一的趋势担心。“基于我们的认识，我要说这项研究正中要害，”来自M.D.安德森癌症中心社区临床肿瘤服务计划的医务主任迈克尔•费希（Michael Fisch）博士说，“你可以从近几年就诊病人的增长看出这个问题来。”2004年，由于越来越长的等待时间, 安德森中心停止为有意到别处就诊的乳腺癌患者提供意见参考服务，而且该中心现正在扩大建筑规模来满足预期的住院需求。“我认为这将影响到每个人，”马萨•米姆斯（Martha Mims）博士，贝勒医学院邓肯中心的临床实验主任说，“虽然休斯顿有两个培训服务计划，但如果我们想要从业护士和初级保健医生帮助照顾病人，还得需要对其进行培训。”根据这一研究，在美国现约有10,400名肿瘤医生执业，每年大约有500名新进劳动力，但现有超过一半的肿瘤医生年龄超过50岁，不久即将退休。虽然年轻的医生在逐渐取代他们，但研究显示需求仍将无法满足。举个例子，好比因为数量有限的投币口，培养预计只能有一个微弱的产出。问卷调查还显示另一种担心，年轻的肿瘤医生因为比他们的老同事更珍视自己的空闲时间，因而未必能接待一样多的病人。
在美国,癌症是仅次于心脏病的第二号杀手。美国癌症协会估计，今年将有近1.4万人被诊断患有癌症,超过560,000将死于这种疾病。被诊断罹患癌症的人数将由2005年的1170万增加到2020年的1820万。由于医生短缺，将会有940万到1510万的诊视缺口。而且癌症的激增是双重的,根据这项研究. 癌症发病率随着年龄增长迅速上升，尤其是在65岁以后，到2020年将增加48%，而带病生存人数将会增加81%后者主要是近来癌症治疗水平提高的结果，尤其在分子水平上靶向治疗肿瘤的药物，往往把肿瘤变为一种慢性疾病。这种治疗还较为复杂,往往需要一个医疗小组。因此，研究人员说，肿瘤专家们将更趋于成为团队领导人，花费更多的时间指导治疗，而减少与单个病人面对面邂逅的机会。但无论如何，研究所说的肿瘤医生短缺将由现在至2020年之间逐渐呈现。届时预计共约有12,500医生提供服务，缺口可高达2550至4080人。
