Cancer: Doctors fear a “silver tsunami” – what that means for Germany

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Humans are getting older. This also poses a challenge for healthcare systems. One factor: there will be more and more cancer patients, because age (along with smoking) is the biggest risk factor. US oncologists are now warning that the increasing number of elderly cancer patients is causing the health systems to collapse.

The world urgently needs to prepare for a global “oncological silver tsunami,” the Guardian quoted a report by the American Society of Clinical Oncology (ASCO). The experts speak of a “serious problem for public health“.

43 percent more new cancer cases worldwide

The experts are assuming an increase in new cancer cases of almost 43 percent. “By 2040, the global burden of growing and aging populations is projected to increase to 27.5 million new cancer cases and 16.3 million cancer deaths,” warns Julie Gralow, ASCO Vice President. For comparison: In 2020, according to the International Agency for Research on Cancer, the number of new cancer cases worldwide was around 19.3 million, and the number of cancer deaths was 9.96 million.

ASCO appeals that action should be taken immediately in order not to be overwhelmed by the dramatic increase in older cancer patients.

“Only” 9 to 15 percent more new cancer cases in Germany

A look at Germany shows a less dramatic situation. Nevertheless, the experts also expect an Antieg in this country. “For Germany, I expect a purely demographically-related increase in new cancer cases by 9 to 15 percent by 2040 compared to 2020,” says Volker Arndt from the German Cancer Research Center to FOCUS online. “In my opinion, the expected increase will therefore be significantly lower in Germany than at the global level.” Specifically, the number of new cases per year will rise from 508,400 (2020) to 555,000 to 587,000 (2040) – depending on the population forecast.

If Reasons for the discrepancy between the German and global trend Arndt says:

Most demographic models do not expect population growth in Germany (compared to many countries in Asia and Africa) until 2040 (76-89 million in 2040 compared to 83 million in 2020). The age structure in Germany is already comparatively old compared to the world standard, so that the demographic aging in this country is less pronounced than globally.

Aging population, understaffing, missing data

Nevertheless, like the rest of the world, Germany faces challenges.

1. Shortage of staff

“The lack of staff is the greatest challenge for all medical care areas, including oncology,” says a spokesman for the German Hospital Society when asked about FOCUS online. “The central challenge of the hospital reform will be to create structures in which we can adequately react to the increasing morbidity of an aging society with the limited human resource.”

In addition, older patients often require “multidisciplinary care”. They often have concomitant illnesses, such as cardiovascular problems, or take other medications, which makes cancer treatment even more complicated.

“If we are dealing with 30 per cent more cancer diagnoses, and those cancer diagnoses are more complex, we will need at least 30 per cent more oncologists, surgeons and pathologists to handle the caseload,” warned Cancer Research UK’s Charles Swanton at the annual ASCO Meeting in Chicago.

2. Missing data

In addition, there is a lack of important data. “Most of the data from clinical trials comes from younger patients. We need to include older patients in studies so we can understand the toxicity and efficacy of therapies in this population,” said ASCO Vice President Gralow.

“One of the major weaknesses in the German healthcare system is definitely the lack of use of data, e.g. for better preventive or early detection systems,” says the spokesman for the German Hospital Society. “We expect that the Health Data Utilization Act (GNDG) will bring us a significant step forward.”

The draft law on the GDNG provides, among other things, for a central office that enables access to research data from various sources. Among other things, it should be possible to link cancer registry, genome and billing data.

3. Lack of geriatric training (geriatrics = geriatric medicine, geriatric medicine)

According to ASCO spokeswoman Gralow, there is also a lack of comprehensive geriatric training to develop suitable care models. The medical field of geriatrics (medicine for the elderly) is still relatively young, but will become increasingly important due to demographic change.

Reform will decide whether the German healthcare system will hold up

Whether the health systems are actually on the brink of collapse will probably depend on how individual countries adapt to the aging population. For Germany, the spokesman for the hospital company says that the risk of an imminent overload cannot (yet) be validly assessed. “It will be essential how the reform takes hold.”

Read here: Lauterbach’s hospital reform: What should change in Germany’s clinics (Deutschlandfunk article)