Several barriers discourage oncology fellows from pursuing careers in cancer prevention and risk-counseling work, according to a new survey study published in the Journal of Clinical Oncology.1

“Reluctance to incorporate cancer prevention into an oncology career seems to stem from lack of mentors and exposure during training, unclear career path, and uncertainty regarding reimbursement,” reported lead study author Carol Fabian, MD, of the University of Kansas Medical Center in Kansas City, KS, and colleagues, on behalf of the American Society of Clinical Oncology (ASCO) Cancer Prevention Workforce Pipeline Work Group. Dr Fabian chairs the Work Group.

For those who navigate their way into cancer prevention, however, the rewards can be profound, Dr Fabian told Cancer Therapy Advisor.


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The Work Group’s initial recommendations include expanding educational resources for fellows, training directors and oncologists; improving funding for prevention training and clinical research; increasing prevention content in clinical-oncology accreditation exams; and working with lawmakers to “broaden the scope and depth of reimbursement for prevention counseling and intervention services.”

They specifically recommended reviving the US National Cancer Institute (NCI)’s Cancer Education and Career Development Program (R25T) funding mechanism for multidisciplinary cancer-prevention mentorship, trainee research, travel funds, and stipends. The R25T program ended in 2013.

“I think it was a real misstep to end that program,” said Shine Chang, PhD, a professor of epidemiology who co-directs MD Anderson’s Cancer Prevention Research Training Program.

“That mechanism was a far superior way to recruit people and provide them with training and experience in cancer prevention research,” Dr. Chang told Cancer Therapy Advisor. “I am very concerned that we’ll not be able to support, sustain, or recreate the infrastructure that had been built over the years through the R25T mechanism over the years. Within the cancer prevention community, it was very well regarded. The trainees did very well and launched to productive careers.”

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Dr. Chang felt so strongly about it that she authored a requiem for the R25T program in 2014.2

Dr. Fabian believes increased opportunities for research would attract more people to the field. “Oncologists like to perform intervention trials. More funding for prevention intervention trials would increase the attractiveness for an academic career in cancer prevention,” she said.