In the US, practicing oncologists showed migration patterns that may leave regional and rural areas with a lack of physicians and contribute to disparities across screening, diagnosis, and treatment of patients with cancer, according to a poster presented at the 2026 ASCO® Annual Meeting.
The authors, led by Jag Lally, MPhil, of University of Rochester Medical Center in New York, recommended that “targeted interventions to ensure adequate geospatial supply of physicians should focus on rural areas and states such as Wyoming and West Virginia.”
The analysis reviewed the Doctors and Clinicians national downloadable file to identify physicians with “Hematology/Oncology” or “Medical Oncology” as a speciality who changed geographic location from August 2020 to August 2025. The researchers used Rural-Urban Continuum Codes to categorize counties as urban or rural. Oncologists who practiced in multiple states were included in all relevant states for analysis.
The overall dataset comprised 12,222 oncologists in 2020 and 13,420 oncologists in 2025. The analysis cohort included 10,172 oncologists present in both datasets, of which 1,233 (12.1%) began practicing in a new state during the five-year period. In this sample, oncologists were more likely to migrate from rural areas to urban areas (N=492; 48.7%) than from urban areas to rural areas (N=380; 4.1%; P<.001). The mean number of years since graduating medical school was 25.1 years for oncologists who began practicing in a new state compared with 28.4 years for oncologists who did not.
The five states with the largest percentage of oncologists gained from net migration were Hawaii at 10.8%, Montana at 6.7%, Vermont at 5.5%, Idaho at 5.5%, and Nebraska at 4.1%. The five states with the latest percentage of oncologists lost were Wyoming at -8.7%, West Virginia at -6.2%, Delaware at -6.2%, Alaska at -4.2%, and Arkansas at -4.1%.
Ultimately, “improving understanding of the underlying factors driving oncologist migration patterns is crucial to ensuring a distributed oncology workforce,” the authors concluded.
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