scarbrtj

Lord Monckton
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Here is the most thorough rundown of "The Numbers" I have yet seen for U.S. radiation oncology. In red I am citing approximate numbers I have seen cited, and I have previously cited, by other reliable sources previously published (on web or in journals etc).

Number of patients getting XRT in 2020:
1,062,600

Rate of increase of new patients getting XRT/year since 2006: 1%
Rate of increase of new doctors treating w/ XRT/year since 2006: ~4%
Number of NEWLY dx patients getting XRT in 2020:
~580,000
Number of new dx ca patients in 2020:
~1,800,000
Estimated incidence of treatment by rad onc on non-newly dx patients on average in 2020: ((1062600-580000)/1062600) = 45%


Average length of treatment in 2010: 4.5 weeks
Average length of treatment in 2020: 3.2 weeks

Number of external beam units in the U.S.: 3770
Number of radiation therapy centers/sites in U.S.: 2280
Sites with IGRT in 2004 vs 2020: 15% vs 90%

The narrative here that the impact of COVID on departments' volumes or $capital$ seems to contradict the story ASTRO has been telling CMS. (The truth is often in the middle!) Also note for the first time I have seen officially documented the drop in fractions and average treatment time over the last 10 years. Unless there's some magic at play that I don't understand (the rate of increase of patients treated with XRT only increasing 1%/year), this would have to mean linacs are less busy (in pure patients/day) in 2020 vs 2010; with more complex/longer treatments, it may or may not mean they're actually less utilized on a pure time basis.

Finally, with ~1 million patients/year getting XRT, and ~5200 rad oncs, would estimate the average TOTAL new starts/year/rad onc in the U.S. to be ~200 (of which ~120 would be newly dx for the year patients).
 
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radiation

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Heres another wrinkle. North american sales (precovid) for both Varian and Elekta up in last few years. Doesnt even count Proton and MRI linac units in the pipeline now

So if there are more machines and excess grads, logic would say somebody is going to figure out how to use these machines. Necessity is the mother of invention...one would hope


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medgator

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Heres another wrinkle. North american sales (precovid) for both Varian and Elekta up in last few years. Doesnt even count Proton and MRI linac units in the pipeline now

So if there are more machines and excess grads, logic would say somebody is going to figure out how to use these machines. Necessity is the mother of invention...one would hope


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Or the used market is going to look great in a few years when a lot of these centers shut down and/or consolidate post APM....
 
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RickyScott

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Cost of used linac not that large in scheme of sheilding/vault, service contract, and tps contract. Varian basically moved to subscription model.
 
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