The need for Chemotherapy will increase by more than 50 percent by 2040

• Team OncoloMed
• 19 December 2020
• 6 min read
• Current issues
• Front Page

The need for Chemotherapy will increase by more than 50 percent by 2040
For everyone out there who envisions a near future without chemotherapy as a central part of the cancer treatment offer, there is now a new study which unfortunately shows how far away we are from such a goal. This is despite a rapid development of new forms of treatment within various cancer diagnoses. The study shows that between 2018 and 2040, patients who need first-line chemotherapy will increase by more than 50%, according to a modeling study published in the world-leading professional journal " The Lancet Oncology" .

This is the first time that researchers have estimated the extent of chemotherapy at the regional, national and global levels, and that Dr. Brooke Wilson and her colleagues from the University of New South Wales together with the "Collaboration for Cancer Outcomes, Research and Evaluation" at the Ingham Institute for Applied Media Research, Australia has done is to measure the number of cancers that required chemotherapy in 2018, and consequently to what extent such cases would probably increase by 2040. Data for the incidence of 29 cancers in 183 countries were obtained from GLOBOCAN 2018 (Global Cancer Incidence Mortality and Prevalence) developed by IARC - International Agency for Research on Cancer.

The study shows that with full use of so-called "evidence-based" guidelines, the number of patients requiring first-line chemotherapy will increase by 53 percent, from 9.8 million in 2018 to 15 million in 2040. However, it should be emphasized that there will be global differences; In 2040, it is estimated that 67% of such patients (10.1 million) will live in countries with low or so-called median income. The global number of cancer cases is expected to increase, especially in these countries. To meet this need, the study also estimates the number of doctors needed in 2018 and 2040 to provide chemotherapy to all patients who will benefit from it: an expansion of oncologists will also be absolutely necessary, from approximately 65,000 oncologists in 2018 to 100 000 in 2040 (median number), provided that each physician does not have more than 150 new chemotherapy patients per year (which is considered to be a maximum reasonable number). The question of how many doctors we actually need will also depend on how we manage to reorganize cancer care to a justifiable level, and that the actual workload for oncologists will vary significantly worldwide. Estimates of the number of oncologists therefore vary from 32,600 to 97,800 doctors in 2018 and 50,000 to 150,000 in 2040.

Wilson points out that the growing cancer burden and the growing demands for chemotherapy globally will present major challenges and crises over the next 20 years, as the gap between available supply and demand is already significant today, especially in low-income and middle-income countries. Strategic decisions and investments to expand the capacity for chemotherapy globally are necessary, the authors point out.

On a global basis, 57.7% of all new cancer cases (9.8 million out of 17 million) needed chemotherapy in 2018. In 2040, the number of new cases of cancer will rise to 26 million, of which 53% (15 million) are expected to need chemotherapy. By 2040, the most common cancers that need chemotherapy will be lung (2.5 million patients) 16.4%, breast (1.9 million patients) 12.7% and colon cancer (1.7 million patients) 11.1%, and the largest absolute increase in new cases will occur for the same three cancers.

The authors also acknowledge in the study that actual chemotherapy use is generally lower than optimal use based on guidelines (for various reasons), and this difference is even greater in low- and middle-income countries, as many patients (and / or countries) cannot afford these costs. There are also other barriers, including the lack of chemotherapy drugs, the infrastructure for drug delivery, supportive pathology and radiation therapy services, and trained personnel. Another limitation of this study is that the age distribution and state of health may change by 2040, but this was not taken into account in the model. The model also assumed that the guidelines for treatment are constant between 2018 and 2040, as future changes based on scientific advances are unpredictable.

In any case, this is both thought-provoking and frightening reading, and also shows in many ways how far we are from solving the cancer mystery.

From OncoloMed's side, we would also like to emphasize that we also interpret the study as a further spur to more use of regional cytotoxic drugs rather than systemic cytotoxic drugs, as the amount of cytotoxic drugs is dramatically reduced when this can be done regionally, and not throughout the body (systemic). This is a form of treatment that is growing rapidly, and which may also change some of the assumptions in the study, see also link to Medias Klinikum here.
https://www.medias-klinikum.de/

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The need for Chemotherapy will increase by more than 50 percent by 2040

For everyone out there who envisions a near future without chemotherapy as a central part of the cancer treatment offer, there is now a new study which unfortunately shows how far away we are from such a goal.