Japan faces alarming shortage of cancer surgeons by 2040 – report
Japan is heading toward a severe shortfall in gastrointestinal surgeons, raising concerns over the future of cancer care as the country’s population ages.
A report by the Japanese Society of Gastroenterological Surgery, presented to the health ministry, projects that the number of gastrointestinal surgeons will fall by 40% by 2040, dropping from around 15,200 today to 9,200. Demand, however, is expected to require nearly 14,400 specialists, leaving a gap of more than 5,000.
The Ministry of Health, Labor and Welfare (MHLW) expert group echoed this warning, projecting that the number of physicians under 65 eligible for society membership will fall from 15,200 in 2025 to 9,200 in 2040, a 39% drop. Even with fewer surgeries needed, this will translate into a shortage of about 5,200 doctors.
The crisis is fueled by ebbing interest among young physicians. Gastrointestinal surgery, which treats cancers of the stomach, colon, and other parts of the digestive tract, is considered one of the most demanding fields. Between 2012 and 2022, the number of surgical gastroenterologists fell 10% to about 19,000, with the decline reaching 15% among doctors under 40. Long, complex operations and frequent emergency procedures during nights and holidays have driven many away.
Meanwhile, cancer cases will continue to rise in the near term. New diagnoses are projected to climb 3%, from 1,025,000 today to a peak of 1,055,000 in 2040, before gradually declining along with the overall population.
The impact is said to vary by region. Smaller cities and depopulating areas are already seeing a reduction in patients, with Akita Prefecture expected to experience over 10% fall by 2040. In contrast, 16 urban prefectures will record increases, with Tokyo and Okinawa forecast to see growth of more than 10%.
Cancer treatment in Japan rests on three main pillars: surgery, radiotherapy, and drug-based therapies such as chemotherapy. While radiotherapy and drug treatments are expected to grow, surgical procedures will decline by 5%, from 465,000 in 2025 to 440,000 in 2040. This reflects fewer cases among the working-age population, who are more likely to undergo surgery.
Health ministry officials warn that Japan’s current cancer care model is unsustainable without major restructuring. A draft report released in July cautioned that even existing surgical treatments “may no longer be sustainable” if reforms are delayed.
To address the problem, the ministry is urging prefectural governments to consider consolidating facilities, staff, and costly equipment. Options include merging hospitals, centralizing services such as radiation therapy, and reallocating resources based on projected patient numbers.
Demographic shifts will reshape demand for treatment. By 2040, cancer cases among patients aged 85 and older are expected to rise in nearly all regions, apart from a few remote rural areas. This will increase demand for radiation therapy by 24% drug therapy by 15%, while surgery dwindles.
Radiation therapy specialists are projected to meet demand through 2040, but maintaining expensive equipment in depopulating areas may prove unsustainable. For drug-based therapies, no clear shortage or surplus of doctors has been identified. However, because these treatments require ongoing, scheduled care, the report recommends expanding telemedicine to ensure access in underserved regions.
The finalized report will soon be distributed to prefectural governments. Regional councils comprising local authorities, hospitals, cancer care providers, and patient groups will then determine how best to respond. The ministry stressed that clear and ongoing communication with the public will be critical in managing expectations and preserving trust as the system adapts.
Japan’s cancer care system is thus caught between rising patient needs and a waning workforce. Without urgent reforms, experts warn, even treatments that are standard today may no longer be guaranteed in the decades ahead.
Sources: Nippon/Asahi Shimbun
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