Today is World Cancer Awareness Day - and with public health researchers predicting the global demand for cancer surgery will rise by 52% within the next 20 years, what does this mean for our medical workforce and population health? 

These alarming statistics were published in The Lancet Oncology by researchers from the University of NSW. Their modelling study analysed cancer surgery demand in 183 countries and estimated surgical and anaesthesia workforce requirements between 2018 and 2040. 

They predicted that cancer surgery numbers will rise from 9.1 million to 13.8 million from 2018 to 2040 – an increase of 52% or - 4.7 million cases. Their research also shows the greatest relative increase will occur in low-income countries, where the number of cases requiring surgery is expected to more than double by 2040.

With cancer being a leading cause of death and disability globally, the study’s lead author Dr Sathira Perera said the findings pointed to the need to substantially increase numbers of surgeons and anaesthetists globally.

Closer to home

In the Northern NSW Local Health District (NNSWLHD), Lismore is home to the North Coast Cancer Institute, which provides a high quality service to many patients with cancer – without them having to travel to bigger cities for treatment. 

So, how are we doing locally as far as cancer surgeries - and will we see a growth in need for cancer treatments?

A NNSWLHD spokesperson said in NSW, cancer surgery activity has increased at a steady rate of about 2.5% each year over the last decade. 

“Surgical activity for cancer has remained stable in Northern NSW LHD over the past decade,” she said.

“There are many factors which influence how these rates will change in the future, including our aging population, increasing incidence of cancer, earlier detection of cancers and the development of new treatments.”

With the need for cancer surgeries growing, what are we doing about increasing medical staff numbers?

“Between mid-2012 and mid-2020, the Northern NSW Local Health District increased its workforce by an additional 1008 full time equivalent staff – an increase of 26.7% - including 171 more doctors, 367 more nurses and midwives, and 121 more allied health staff,” the spokesperson said.

"The 2019-20 budget for Northern NSW Local Health District was $875 million. This is an increase of $37 million on the previous financial year’s annualised budget.”

Shortage of medical staff globally

UNSW researcher Dr Perera said globally, there was a current shortage of 199,000 surgeons and 87,000 anaesthetists.

“This is based on the current workforce of 766,000 surgeons and 372,000 anaesthetists, compared with 965,000 and 459,000 needed for an optimal workforce, respectively, in our modelling study,” he said.

“The gap is estimated to be greatest in low-income countries

“We need better planning and there needs to be an increased focus on the application of cost-effective models of care, along with government endorsement of scientific evidence to mobilise resources for expanding services,” Dr Perera said.

“In addition, access to post-operative care is strongly linked to lower mortality – so, improving care systems globally must be a priority in order to reduce the disproportionate number of deaths following complications.”

About the study

The modelling study was an international collaboration between researchers from UNSW Sydney, University of Toronto, Kings College London, and the World Health Organization.

The researchers used best-practice guidelines, patient characteristics and cancer stage data to calculate the proportion of newly diagnosed cancer cases requiring surgery in 183 countries.

To deliver cancer surgery services optimally now and in future, the researchers also predicted requirements for surgical and anaesthesia workforces. To evaluate current staffing gaps, they compared the optimal estimated workforce (the median workforce of 44 high-income countries) with the number of surgeons and anaesthetists in each country.

The researchers acknowledged that estimates in their study relied on several assumptions.

“We based predictions of future cancer rates on 2018 estimates, but country-level changes – such as economic developments or altered capacity to screen for early diagnosis – could impact cancer incidence and therefore surgical demand and workforce requirements,” Dr Perera said.