Abstract
Background: Over the next two decades, the US population will experience dramatic growth in the number and relative proportion of older individuals. The aim of this study was to quantify the effect of these changes on the demand for oncological procedures.
Methods: The 2000 Nationwide Inpatient Sample and the 1996 National Survey of Ambulatory Surgery were used to compute age-specific incidence rates for oncological procedures of the breast, colon, rectum, stomach, pancreas, and esophagus. Procedure rates were combined with census projections for 2010 and 2020 to estimate the future utilization of each procedure.
Results: By 2020, the number of patients undergoing oncological procedures is projected to increase by 24% to 51%. The bulk of growth in procedures is derived from outpatient procedures, but significant growth will also be seen in inpatient procedures.
Conclusions: The aging of the population will generate an enormous growth in demand for oncological procedures. If a shortage of surgeons performing these procedures does occur, the result will inevitably be decreased access to care. To prevent this from happening, the ability of surgeons to cope with an increased burden of work needs to be critically evaluated and improved.
Similar content being viewed by others
REFERENCES
Anderson RN, DeTurk PB. United States Life Tables, 1999 (National Vital Statistics Report, Vol 50, No. 6). Hyattsville, MD:: National Center for Health Statistics, 2002.
Population Change and Distribution. Census 2000 Brief. US Department of Commerce: Economics and Statistics Administration
Popovic J. 1999 National Hospital Discharge Survey: Annual Summary With Detailed Diagnosis and Procedure Data. Hyattsville, MD:: National Center for Health Statistics, 2001.
InstitutionalAuthorNameGraduate Medical Education National Advisory Committee. (1980) Summary Report of the Graduate Medical Education National Advisory Committee to the Secretary, Department of Health and Human Services, September 20, 1980. Vol 1. Department of Health and Human Services Hyattsville, MD:
Etzioni DA, Liu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg 2003;238:170–7.
Kwakwa F, Biester TW, Ritchie WP Jr, Jonasson O. Career pathways of graduates of general surgery residency programs: an analysis of graduates from 1983 to 1990. J Am Coll Surg 2002;194:48–53.
Inciardi JF, Lee JG, Stijnen T. Incidence trends for colorectal cancer in California: implications for current screening practices. Am J Med 2000;109:277–81.
Cress RD, Morris CR, Wolfe BM. Cancer of the colon and rectum in California: trends in incidence by race/ethnicity, stage, and subsite. Prev Med 2000;31:447–53.
Swan J, Breen N, Coates RJ, et al. Progress in cancer screening practices in the United States: results from the 2000 National Health Interview Survey. Cancer 2003;97:1528–40.
Breen N, Wagener DK, Brown ML, et al. Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst 2001;93:1704–13.
Mandel JS, Church TR, Bond JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 2000;343:1603–7.
Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 1993;328:1365–71.
Bland KI, Isaacs G. Contemporary trends in student selection of medical specialties: the potential impact on general surgery. Arch Surg 2002;137:259–67.
Henningsen JA. Why the numbers are dropping in general surgery: the answer no one wants to hear—lifestyle!. Arch Surg 2002;137:255–6.
Organ CH Jr. The generation gap in modern surgery. Arch Surg 2002;137:250–2.
American Board of Thoracic Surgery. Notice From the American Board of Thoracic Surgery, 2001. Available at: http://www.ctsnet.org/doc/6678. Accessed July 1, 2003.
American Board of Thoracic Surgery. Am Board Vasc Surg Newslett 2002 (Spring). Available at: http://www.vascularweb.org/file/newsletter.pdf. Accessed July 3, 2003.
Zelenock GB, Stanley JC, More RA, et al. Differential clinical workloads among faculty at a major academic health center. Ann Surg 1997;226:336–45; discussion 345–7.
Medical Group Compensation & Productivity Survey. Alexandria, VA: American Medical Group Association, 2002.
Druss BG, Marcus SC, Olfson M, et al. Trends in care by nonphysician clinicians in the United States. N Engl J Med 2003;348:130–7.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Etzioni, D.A., Liu, J.H., Maggard, M.A. et al. Workload Projections for Surgical Oncology: Will We Need More Surgeons?. Ann Surg Oncol 10, 1112–1117 (2003). https://doi.org/10.1245/ASO.2003.03.034
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1245/ASO.2003.03.034