Where Have We Been and Where Are We Going? The State of the Hematology and Medical Oncologist Workforce in America.

purposeTo identify geographic areas and populations in the United States likely to experience challenges accessing cancer care.

methodsWe tabulated the number of hematologists and medical oncologists billing Medicare nationally, by state, and by county in 2014, 2019, and 2024, and assessed trends over time, offset by the US population age 55 years and older (where 80% of new cancers are diagnosed). We identified counties with oncologist presence, those with ≥25% of oncologists in late-career phases that could face reduced oncology care coverage in the future, as well as counties adjacent and nonadjacent to counties with oncologists, and outlined differences in populations residing in those counties. We characterized the current oncologist workforce by demographics and features of where they practice, stratified by career stage.

resultsAs the number of oncologists increased from 12,267 in 2014 to 14,547 in 2024, the number per 100,000 population age 55 years and older decreased from 15.9 to 14.9. In 2024, 38 states had fewer oncologists per capita than in 2014, with most facing limited rural workforce coverage. Although 89% of the population lived in counties with oncologists, 68% of the population lived in counties where more than a quarter of oncologists were nearing retirement age. Early-career clinicians were less likely than their later-career counterparts to work in counties that were rural or had high rates of cancer mortality, smoking, obesity, social vulnerability, uninsurance, and homes without broadband Internet access.

conclusionGaps in oncologist coverage across the country exist, especially among rural populations and those with high cancer burden and socioeconomic risk. Understanding the geographic coverage of oncologists could facilitate efforts to improve patient access to cancer care.