Recent population-level trends in utilization of outpatient medical oncology services

Purpose — Despite growing demand for medical oncology services, there is limited literature on trends in service utilization, and current workload models focus solely on incident caseloads. We characterized population-level trends in outpatient medical oncology service utilization among patients diagnosed with common solid tumors.

Methods — A cohort of all patients age ≥18 years, diagnosed between January 2015 and December 2022 with one of the seven solid tumors (lung, colon, rectal, pancreas, breast, melanoma, or prostate cancer) was identified from the Ontario Cancer Registry. Administrative data were used to assess cancer incidence, and medical oncologist and systemic therapy outpatient visits during the first 2 years following the initial medical oncology consultation; analyses were stratified by year of diagnosis.

Results — The cohort consisted of 332,604 patients across the seven target cancers. Although we observed a modest increase in the number of new incident cancer cases per year (39,688 in 2015 to 45,011 in 2022) and the proportion of new patients with a consult with a medical oncologist (0.4%-5.3%), with the exception of pancreatic cancer (19.2%), these changes translated to a large absolute increase of 3,589 more consultations and 43,193 more follow-ups annually in the first year following initial consultation. The absolute number of systemic therapy visits during the first year increased by 36,185 visits during the same time period, with utilization remaining high in the second year.

Conclusion — There has been a substantial rise in medical oncology outpatient health services utilization with more patients seeing a medical oncologist and going on to receive systemic treatment. These findings highlight the critical need for new comprehensive, data-driven medical oncology workforce requirements models that capture the complexity of delivering modern medical oncology care.