Disparities in Global Oncology Workforce Have Consequences for Cancer Care

Amid a rising cancer burden worldwide, shortages of oncologists can lead to limited access to lifesaving treatments for patients and increase the workload on physicians. Even in high-income nations like the United States, there is an estimated deficit of 2250 medical oncologists projected to remain unresolved. In countries with lower median incomes, there are very few trained oncologists available to provide vital care. According to findings presented at the European Society for Medical Oncology (ESMO) Congress 2025, 92.2% of the total oncology workforce is in high- and upper middle–income countries.¹

Looking at rates of cancer diagnoses worldwide, this translates to approximately 1 oncologist per 256 new cancer cases annually in high-income countries. In the lowest-income countries, the situation is dire, with a ratio of only 1 oncologist per 7160 new cases. Because of the complexity of cancer treatment, shortages in other specialties also prevent patients from getting the best possible care.

In an interview with Targeted Oncology, David J. Benjamin, MD, a genitourinary medical oncologist at the Hoag Family Cancer Institute in Newport Beach, California, discussed the findings he presented at ESMO after reviewing 82 separate sources of data, the implications of insufficient access to cancer care, and how better systematic collection of data on physician availability is the first step to addressing the global shortages in medical oncology and beyond.

Targeted Oncology: What motivated you to research the global oncology workforce?

David J. Benjamin, MD: There were a couple of reasons we wanted to undertake this study, the first being that there are several studies that have been showing the burden of cancers growing globally. If we look at the statistics from 3 years ago, there were an estimated 20 million new cases of cancer and 9.7 million deaths.² Unfortunately, we look at the data and estimates looking forward into the next 25 years, those numbers are expected to double, with 35 million new cases of cancer and approximately 18 million deaths. During this time, there are concerns about the workforce. If we look at the medical oncology workforce in the United States, there’s an estimated deficit of 2250 medical oncologists in the United States this year alone.¹ But looking forward, this deficit is expected to still be about 2000 medical oncologists by the year 2037.

Given that we know the burden of cancer is growing, there are concerns about the workforce in countries like the United States, but it goes beyond the United States. There are news articles from the United Kingdom, Malaysia, spanning multiple continents where there are concerns about the workforce. My colleagues and I wanted to better understand the medical oncology workforce on the global scale. Also, we want to understand, are there disparities in accessing a medical oncologist depending on the country or the region?

What were your findings about the numbers of medical oncologists worldwide?

We utilized a number of resources: public health data, publicly available, government documents, oncology society publications, and we ultimately estimated that there are about 83,000 medical oncologists globally. We stratified these countries based off the region, using the World Bank definition of high-, upper middle–, lower middle–, and low-income countries, and we found that there are differences in the number of oncologists depending on these regions when we stratified based off the income. The World Bank classifies these different incomes based off gross national income per capita. If you look at the high-income countries, including the United States, all those countries together, there are about 30,400 medical oncologists. If we go to upper middle–income countries, that number actually goes up to 46,140, but when we go to the lower middle–income countries, there is a marked drop-off to about 6370. What I found most striking in our study was that in the low-income countries, there are only a total of 70 medical oncologists among all those countries combined.

What effect does the lack of medical oncologists have on patients who are diagnosed with cancer?

If we look at some of these countries, for example, the low-income countries where there’s a total of 70 medical oncologists among all those nations, there are some countries where there’s simply 1 medical oncologist for the whole country that we know of, or there are no medical oncologists. What this means for those with cancer is that…they may not be able to travel to see this medical oncologist, or if there’s no medical oncologist, they have to resort to traveling outside of their country, if they have the means to do so.

Unfortunately, for a lot of individuals in these countries where they don’t have the economic means, they oftentimes resort to palliative care, meaning they are provided with supportive care for their symptoms like pain, and that’s assuming that they have access to a supportive care physician. Oftentimes, many of these countries have no physician at all to take care of them.

How do these findings compare with the availability of other specialties or physicians in general?

We didn’t specifically look at the number of physicians in each country, although from the limited literature search, there are not a lot of data out there on the number of, for example, internal medicine physicians. I think it brings up a good point that medical oncology is just 1 aspect of oncology care. When we think about the other physicians who are needed—for example, radiation oncologists, surgical oncologists, pathologists to do the biopsy and to understand what the diagnosis is, [and] radiologists to read the CT scan or the MRI—we don’t know the full depth of the potential shortage in the physicians who are needed to diagnose and properly treat a case of cancer. What I can say about the disparities in access to a medical oncologist is that, for example, in high-income countries, there’s 1 oncologist for every 256 new cases. In the low-income countries, that ratio goes up to 1 oncologist for every 7160 new cases.

We looked at the data from…the World Health Organization. They do have a ratio of the number of physicians for every 1000 people in those countries. If we look at, for example, North America or the European Union, that ratio is generally about 4 physicians for every 1000 people.³ But if we look at low-income countries, most of the data suggest that ratio is [between] 0.4 [and] 0.7 physicians for every 1000 people. I think what we see in the data for physicians for the general population does translate somewhat into our ratio, where we see the number of new cases of cancer for 1 oncologist, depending on the income stratification of these countries.

How can these findings be developed further to identify and address these disparities?

There are several takeaways from our study, the first being that we saw there are differences in the number of medical oncologists depending on countries when we stratify them based off their income. But some of the other pertinent findings of our study are that there is a lack of data in the medical oncology workforce for several of these countries. Some of them are data sets based off expert opinion, not from a formal registry. The last point is that some of the data are not routinely updated. If we look at a country like the United States, the American Society of Clinical Oncology generally publishes the data every year or every 2 years, but in some of these countries, they were not updated in over 5 years.

The next step to identify and keep track of the workforce may be a centralized monitoring system. It may not necessarily be 1 system, but it could be, depending on the country or the region, so it can help identify the oncologists who are in training [and] the oncologists once they’re part of the workforce. We know there are issues with physician burnout in many countries. How do we retain these physicians to help provide clinical care? Then…we know that in countries like the United States, almost a quarter of the oncologists are close to retiring. Once we have a centralized monitoring system, we can identify potential gaps for access to care and then ultimately come up with potential solutions to provide this essential cancer care.

What steps can be taken to address the oncology workforce shortages?

I think this is 1 of the issues that our study identified, where we still don’t have a centralized monitoring system. Oftentimes, it’s dependent on the oncology society of that country or that region, but there still isn’t a centralized database. Our study was one of the first to identify, at least in the modern setting in 2025, that there is a lack of data or a lack of timely updates to the data. Our goal, as my coauthors and I have sought out, is to first identify that there are issues in access to care, and hopefully bring up this discussion: How do we as a global community move forward and identify and keep track of the workforce?, as a global community,

REFERENCES

1. Benjamin DJ, Jenei K, Lythgoe MP. The global medical oncology workforce, 2025: disparities in access to care. Presented at: ESMO Congress 2025; October 17-20, 2025; Berlin, Germany. Abstract 22750.

2. Filho AM, Laversanne M, Ferlay J, et al. The GLOBOCAN 2022 cancer estimates: data sources, methods, and a snapshot of the cancer burden worldwide. Int J Cancer. 2025;156(7):1336-1346. doi:10.1002/ijc.35278

3. World Health Organization. World health statistics 2025: monitoring health for the SDGs, sustainable development goals. Accessed November 17, 2025. https://www.who.int/publications/i/item/9789240110496