title: The impact of computed tomographic screening for lung cancer on the thoracic surgery workforce.
abstract: BACKGROUND
  This study aimed to predict variation in the thoracic surgery workforce requirements with the introduction of a national chest computed tomographic (CT) screening program for individuals at high risk of lung cancer.
  
  
  METHODS
  Using Canadian census microdata and the Canadian Community Health Survey, a microsimulation model representing the national population was developed. The demand component simulates the incidence of lung cancer, whereas the supply component simulates the number of practicing thoracic surgeons. A national CT screening program in high-risk individuals (>30 pack-year history of smoking; age, 55-74 years) was introduced into the model to predict changes in the number of operable lung cancers per thoracic surgeon.
  
  
  RESULTS
  From 2013 to 2040, the Canadian population increased from 34 to 43 million. The number eligible for screening varies from 1,112,800 (2013) to 513,200 (2040), peaking at 1,147,700 (2017). Comparing CT screening with chest radiography, overall lung cancer diagnoses increase 7.3% by 2040, with stage 1A increasing by 15.6% and stage IV decreasing by 7.5%. The rate of operable early lung cancers per thoracic surgeon increases by 24.2% (2020), 19.8% (2030), and 16% (2040), with CT screening relative to the baseline increase seen with chest radiography.
  
  
  CONCLUSIONS
  With the implementation of a CT screening program there will be an increase in operable lung cancers, resulting in increased surgical volume. A national strategy for the thoracic surgery workforce is necessary to ensure that an appropriate number of surgeons are being trained to meet the future needs of the national population.
authors: Division of Thoracic Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: janetpatriciaedwards@gmail.com.
authors: Janet P
authors: JP
authors: Edwards
authors: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Indraneel
authors: I
authors: Datta
authors: Department of Civil Engineering, University of Calgary, Calgary, Alberta, Canada.
authors: John Douglas
authors: JD
authors: Hunt
authors: HBA Specto Inc, Calgary, Alberta, Canada.
authors: Kevin
authors: K
authors: Stefan
authors: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Chad G
authors: CG
authors: Ball
authors: Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Elijah
authors: E
authors: Dixon
authors: Division of Thoracic Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Sean C
authors: SC
authors: Grondin
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008875:Middle Aged; D015233:Models, Statistical; D013903:Thoracic Surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D000078329:Workforce