TY - JOUR
T1 - Distribution of the workforce involved in cancer care
T2 - a systematic review of the literature
AU - Trapani, D.
AU - Murthy, S. S.
AU - Boniol, M.
AU - Booth, C.
AU - Simensen, V. C.
AU - Kasumba, M. K.
AU - Giuliani, R.
AU - Curigliano, G.
AU - Ilbawi, A. M.
N1 - Funding Information:
We acknowledge Dr Catherine Lam and Daniel Moreira from St Jude Children's Hospital for the help provided and inputs in developing the research strategy for the childhood cancer workforce. We also acknowledge the contribution of Dr Elena Fidarova from WHO, for the important inputs on the radiation therapy workforce. We thank the European Society for Medical Oncology, for supporting this work, and the ESMO leadership for providing valuable comments and edits on the final proof, including an articulated revision from Prof G. Pentheroudakis, under the coordination or Mrs Vyas and Mrs Bricalli. None declared. GC reports consultancy from Bristol Myers Squibb, Lilly, Novartis, Pfizer, Roche, Seagen, and Daiichi Sankyo; employment at the University of Milano, Istituto Europeo di Oncologia, IRCCS, Milano, Italy; and speaker's bureau participation for Lilly, Pfizer, Roche, Seagen, and Daiichi Sankyo. AI and MB are employees of WHO. The other authors have declared no conflicts of interest.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Background: A skilled health workforce is instrumental for the delivery of multidisciplinary cancer care and in turn a critical component of the health systems. There is, however, a paucity of data on the vast inequalities in cancer workforce distribution, globally. The aim of this study is to describe the global distribution and density of the health care workforce involved in multidisciplinary cancer management. Methods: We carried out a systematic review of the literature to determine ratios of health workers in each occupation involved in cancer care per 100 000 population and per 100 cancer patients (PROSPERO: protocol CRD42018095414). Results: We identified 33 eligible papers; a majority were cross-sectional surveys (n = 16). The analysis of the ratios of health providers per population and per patients revealed deep gaps across the income areas, with gradients of workforce density, highest in high-income countries versus low-income areas. Benchmark estimates of optimal workforce availability were provided in a secondary research analysis: mainly high-income countries reported workforce capacities closer to benchmark estimates. A paucity of literature was defined for critical health providers, including for pediatric oncology, surgical oncology, and cancer nurses. Conclusion: The availability and distribution of the cancer workforce is heterogeneous, and wide gaps are described worldwide. This is the first systematic review on this topic. These results can inform policy formulation and modelling for capacity building and scaleup.
AB - Background: A skilled health workforce is instrumental for the delivery of multidisciplinary cancer care and in turn a critical component of the health systems. There is, however, a paucity of data on the vast inequalities in cancer workforce distribution, globally. The aim of this study is to describe the global distribution and density of the health care workforce involved in multidisciplinary cancer management. Methods: We carried out a systematic review of the literature to determine ratios of health workers in each occupation involved in cancer care per 100 000 population and per 100 cancer patients (PROSPERO: protocol CRD42018095414). Results: We identified 33 eligible papers; a majority were cross-sectional surveys (n = 16). The analysis of the ratios of health providers per population and per patients revealed deep gaps across the income areas, with gradients of workforce density, highest in high-income countries versus low-income areas. Benchmark estimates of optimal workforce availability were provided in a secondary research analysis: mainly high-income countries reported workforce capacities closer to benchmark estimates. A paucity of literature was defined for critical health providers, including for pediatric oncology, surgical oncology, and cancer nurses. Conclusion: The availability and distribution of the cancer workforce is heterogeneous, and wide gaps are described worldwide. This is the first systematic review on this topic. These results can inform policy formulation and modelling for capacity building and scaleup.
KW - cancer workforce
KW - capacity-building
KW - global cancer policy
KW - medical oncology workforce
KW - national cancer control planning
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U2 - 10.1016/j.esmoop.2021.100292
DO - 10.1016/j.esmoop.2021.100292
M3 - Review article
AN - SCOPUS:85118829628
SN - 2059-7029
VL - 6
JO - ESMO Open
JF - ESMO Open
IS - 6
M1 - 100292
ER -