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• W2945844898 abstract "The purpose for this manuscript is to enhance career opportunities for radiation oncologists (ROs) by expanding the scope of work as a prelude to redefining the scope of our contributions at this critical inflection point in our history. The direct stimulus is the speculation and debate over the ROs' future, a logical issue in today's rapidly changing world of health care economics, cancer biology, artificial intelligence, and global resource disparities.1Falit B.P. Pan H.Y. Smith B.D. Alexander B.M. Zietman A.L. The radiation oncology job market: The economics and policy of workforce regulation.Int J Radiat Oncol Biol Phys. 2016; 96: 501-510Abstract Full Text Full Text PDF PubMed Google Scholar, 2Pan H.Y. Haffty B.G. Falit B.P. et al.Supply and demand for radiation oncology in the united states: Updated projections for 2015 to 2025.Int J Radiat Oncol Biol Phys. 2016; 96: 493-500Abstract Full Text Full Text PDF PubMed Google Scholar, 3Royce T.J. Katz M.S. Vapiwala N. Training the radiation oncology workforce of the future: Course correction to supply the demand.Int J Radiat Oncol Biol Phys. 2017; 97: 881-883Abstract Full Text Full Text PDF PubMed Google Scholar, 4Smith B.D. Haffty B.G. Wilson L.D. Smith G.L. Patel A.N. Buchholz T.A. The future of radiation oncology in the United States from 2010 to 2020: Will supply keep pace with demand?.J Clin Oncol. 2010; 28: 5160-5165Crossref PubMed Scopus (89) Google Scholar, 5Fung C.Y. Chen E. Vapiwala N. et al.The American Society for Radiation Oncology 2017 radiation oncologist workforce study.Int J Radiat Oncol Biol Phys. 2019; 103: 547-556Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar, 6Sura K. Lischalk J.W. Grills I.S. Mundt A.J. Wilson L.D. Vapiwala N. Modern perspectives on radiation oncology residency expansion, fellowship evolution, and employment satisfaction.J Am Coll Radiol. 2019; 16: 749-753Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar To be proactive and effective in adapting to—and with—these external factors, the data upon which decisions are based should be well understood. Yet accuracy of workforce forecasts for ROs are notoriously inconsistent, partly because of the imperfect assumptions inherent in such complex models.1Falit B.P. Pan H.Y. Smith B.D. Alexander B.M. Zietman A.L. The radiation oncology job market: The economics and policy of workforce regulation.Int J Radiat Oncol Biol Phys. 2016; 96: 501-510Abstract Full Text Full Text PDF PubMed Google Scholar, 2Pan H.Y. Haffty B.G. Falit B.P. et al.Supply and demand for radiation oncology in the united states: Updated projections for 2015 to 2025.Int J Radiat Oncol Biol Phys. 2016; 96: 493-500Abstract Full Text Full Text PDF PubMed Google Scholar, 3Royce T.J. Katz M.S. Vapiwala N. Training the radiation oncology workforce of the future: Course correction to supply the demand.Int J Radiat Oncol Biol Phys. 2017; 97: 881-883Abstract Full Text Full Text PDF PubMed Google Scholar, 4Smith B.D. Haffty B.G. Wilson L.D. Smith G.L. Patel A.N. Buchholz T.A. The future of radiation oncology in the United States from 2010 to 2020: Will supply keep pace with demand?.J Clin Oncol. 2010; 28: 5160-5165Crossref PubMed Scopus (89) Google Scholar Nonetheless, over 50% of ROs are concerned about a future oversupply,5Fung C.Y. Chen E. Vapiwala N. et al.The American Society for Radiation Oncology 2017 radiation oncologist workforce study.Int J Radiat Oncol Biol Phys. 2019; 103: 547-556Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar, 6Sura K. Lischalk J.W. Grills I.S. Mundt A.J. Wilson L.D. Vapiwala N. Modern perspectives on radiation oncology residency expansion, fellowship evolution, and employment satisfaction.J Am Coll Radiol. 2019; 16: 749-753Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar and the downstream effects already appear to have negatively affected specialty choice among highly talented and pragmatic medical students. Discussions of practitioner supply and demand imbalance often focus on the numerator—are there too many? Better solutions may reside in a broadening of the denominator—the talent and contributions that ROs bring to cancer care and greater society.7Coleman C.N. Prasanna P.G.S. Bernhard E.J. et al.Accurate, precision radiation medicine: A meta-strategy for impacting cancer care, global health, and nuclear policy and mitigating radiation injury from necessary medical use, space exploration, and potential terrorism.Int J Radiat Oncol Biol Phys. 2018; 101: 250-253Abstract Full Text Full Text PDF PubMed Google Scholar, 8Vapiwala N. Shulman L.N. Thomas C.R. Care provider or service provider: What should the role of radiation oncologists be in the future?.J Oncol Pract. 2018; 14: 81-83Crossref PubMed Scopus (1) Google Scholar Regardless of how one views these complex issues, this is a critical juncture for exploring how to evolve ROs' skills and ensure that our contributions continue to help solve the challenges facing health care and patients. Innovation and consideration of nontraditional paths should be a key part of the strategy to maintain our relevance and proactively address transformational changes in health care delivery models, medical science, and information technology. The “adoption life cycle” for innovation predicts a bell curve distribution of uptake over time with innovators at one end and skeptics and phobics on the other.9Iowa State College Agriculture Extension ServiceThe diffusion process.https://lib.dr.iastate.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1015&context=specialreportsDate accessed: October 10, 2018Google Scholar Health care adopts change judiciously, and appropriately so, pending establishment of safety and efficacy. Presently, ROs represent a significant investment and subsequent revenue generator for health care enterprises. Some may feel threatened by the rapid evolution of systemic therapy, radiation therapy indications, and the fourth industrial revolution, where smart technologies are redefining, if not replacing, jobs requiring manual skill and human decision making. But ROs could also benefit from some of these changes, which are inevitable and exponential. We must adapt creatively. Clayton Christensen describes concepts that can help one to manage (and thrive under) disruptive, catalytic, and reverse innovation.10Christensen C.M. Baumann H. Ruggles R. Sadtler T.M. Disruptive innovation for social change.Harv Bus Rev. 2006; 84: 94-101PubMed Google Scholar, 11Bower J.L. Christensen C.M. Disruptive technologies: Catching the wave.Harv Bus Rev. 1995; 73: 45-53Google Scholar, 12Govindarajan V. Trimble C. Nooyi I.K. Reverse Innovation: Create Far From Home, Win Everywhere. Harvard Business Review Press, Boston, MA2012Crossref Scopus (5) Google Scholar, 13Ahmed M.M. Coleman C.N. Mendonca M. et al.Workshop report for cancer research: Defining the shades of Gy: Utilizing the biological consequences of radiotherapy in the development of new treatment approaches—meeting viewpoint.Cancer Res. 2018; 78: 2166-2170Crossref PubMed Scopus (2) Google Scholar Expanding radiation's therapeutic applications and technical capabilities are absolutely vital steps. This paper advocates for the parallel development of our workforce through opportunities in broader domains (Fig. 1). Herein we review some underappreciated careers with colleagues who have successfully charted these paths using their unique strengths as ROs to further diversify their skill sets, enrich their professional roadmap, and expand demand, that is, that critical denominator. Far from exhaustive, this compendium provides a vision for how future ROs can do meaningful and influential work through activities that expand the definition of ROs' work-product, inspiring continued training, adaptation, and evolution of our workforce (owing to page limitations, a high-level discussion is presented here with additional details available in the references). ROs increasingly express interest in global medicine initiatives. Establishing cancer care in resource-constrained settings requires partnerships, resources, and sustainable training models. Remediating the situation wherein patients have no access to cancer care is a global imperative. Strong relationships between in-country leadership, care providers, and paired organizations are requisite. Examples of how ROs can lead and significantly expand these critical initiatives include the following:•The Asia-Pacific Special Interest Group of the Royal Australian and New Zealand College of Radiologists Faculty of Radiation Oncology aim to support provision of quality radiation therapy in low- and middle-income countries (LMICs). A key collaboration with the comprehensive Cambodian National Cancer Center has enabled provision of radiation therapy services since April 2018 and funding for Cambodian oncology professionals to train in Australia and Australasian staff to volunteer in Cambodia.•The University of Pennsylvania has established an oncology collaboration with the University of Botswana and the nation's Ministry of Health and Wellness. This partnership is developing programmatic initiatives including streamlined multidisciplinary care,14Grover S. Chiyapo S.P. Puri P. et al.Multidisciplinary gynecologic oncology clinic in Botswana: A model for multidisciplinary oncology care in low- and middle-income settings.J Glob Oncol. 2017; 3: 666-670Crossref PubMed Google Scholar guideline development, technical support for new radiation centers, timely chemotherapeutic drug delivery,15Martei Y.M. Chiyapo S. Grover S. et al.Availability of WHO essential medicines for cancer treatment in Botswana.J Glob Oncol. 2018; 4: 1-8Google Scholar and complementary research initiatives. Consequently, a robust framework for training and bidirectional exchange of oncology professionals has emerged,16Thompson R.F. Grover S. A resident’s perspective on global health rotations in radiation oncology.Int J Radiat Oncol Biol Phys. 2015; 93: 1165-1166Abstract Full Text Full Text PDF PubMed Google Scholar allowing US-based trainees to gain experience in LMIC settings and further integrate global radiation oncology into their careers.17Grover S. Balogun O.D. Yamoah K. et al.Training global oncologists: Addressing the global cancer control problem.Front Oncol. 2015; 5: 80PubMed Google Scholar, 18Olson A.C. Coleman C.N. Hahn S.M. et al.A roadmap for a new academic pathway for global radiation oncology.Int J Radiat Oncol Biol Phys. 2015; 93: 493-496Abstract Full Text Full Text PDF PubMed Google Scholar•Not all LMIC nations have comprehensive radiation therapy training; for example, Russian physicians can complete a 2-year oncology residency program covering all aspects of cancer care, but this is mainly a self-learning process with no didactic curriculum. To achieve primary radiation oncology specialization, physicians receive additional training that lasts 2.5-4 months but that includes no practical exposure to structure contouring or treatment planning.19Likhacheva A. Mitin T. Khmelevsky E. The red beam: Past, present, and future of radiation oncology in Russia.Int J Radiat Oncol Biol Phys. 2017; 97: 220-224Abstract Full Text Full Text PDF PubMed Google Scholar In 2016, US and Russian academic ROs piloted an in-person, expert-led contouring workshop20Mitin T. Fundamentals of target delineation in radiation therapy for breast cancer[in Russian].Date accessed: October 10, 2018Google Scholar; subsequently, 15 contouring workshops covering various disease sites were conducted in Russia with financial support from the Russian Society of Clinical Oncology. The Lancet Oncology Commission report by the Global Task Force on Radiotherapy identified the lack of qualified human resources as a main barrier to providing adequate radiation therapy services in LMICs.21Atun R. Jaffray D.A. Barton M.B. et al.Expanding global access to radiotherapy.Lancet Oncol. 2015; 16: 1153-1186Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar It indicated a need to train 30,000 ROs, 22,100 medical physicists, and 78,300 radiation technologists over the next 20 years,21Atun R. Jaffray D.A. Barton M.B. et al.Expanding global access to radiotherapy.Lancet Oncol. 2015; 16: 1153-1186Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar numbers that cannot be achieved without a major paradigm shift in training pathways. Lack of universal acknowledgment of the legitimacy of a global health career is a roadblock to progress.22Rodin D. Yap M.L. Grover S. et al.Global health in radiation oncology: The emergence of a new career pathway.Semin Radiat Oncol. 2017; 27: 118-123Crossref PubMed Scopus (4) Google Scholar The push for innovation requires leadership by LMICs. Interested ROs can develop curricula and training materials with existing agencies: (1) for guidance, the World Health Organization published a list of priority medical devices for cancer management23World Health OrganizationWHO List Of Priority Medical Devices for Cancer Management. World Health Organization, Geneva2017Google Scholar; (2) the International Atomic Energy Agency (IAEA) publishes how-to guides for establishing and maintaining high-quality radiation therapy departments24International Atomic Energy Agency. Setting Up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects. Available at: https://www.iaea.org/publications/7694/setting-up-a-radiotherapy-programme. Accessed June 20, 2019.Google Scholar, 25International Atomic Energy AgencyPlanning National Radiotherapy Services: A Practical Tool. International Atomic Energy Agency, Vienna, Austria2011Google Scholar and supports projects in over 130 countries, including radiation therapy education, randomized clinical trials, quality assurance activities, virtual tumor boards, in-person and online courses, and other resources. One need not travel abroad to serve low-income and resource-strapped populations. Rural America's patients with cancer and providers in geographically isolated areas face unique challenges in receiving and delivering optimal care, similar to LMICs. System barriers in rural areas are well documented; 19% of the US population lives in census-designated rural areas, yet only 6% of oncology providers practice there, with ROs especially concentrated in nonrural areas.26American Society of Clinical Oncology The state of cancer care in America, 2017: A report by the American Society of Clinical Oncology.J Oncol Pract. 2017; 13: e353-e394Crossref PubMed Scopus (50) Google Scholar Distance to cancer centers is a significant determinant of radiation receipt.27Ward M.M. Ullrich F. Matthews K. et al.Where do patients with cancer in Iowa receive radiation therapy?.J Oncol Pract. 2014; 10: 20-25Crossref PubMed Scopus (13) Google Scholar Rural settings have lower cancer-screening rates and delayed management of abnormal results.28Guadagnolo B. Petereit D. Coleman C. Cancer care access and outcomes for American Indian populations in the United States: Challenges and models for progress.Semin Radiat Oncol. 2017; 27: 143-149Crossref PubMed Scopus (8) Google Scholar, 29Meilleur A. Subramanian S.V. Plascak J.J. Fisher J.L. Paskett E.D. Lamont E.B. Rural residence and cancer outcomes in the US: Issues and challenges.Cancer Epidemiol Biomarkers Prev. 2013; 22: 1657-1667Crossref PubMed Scopus (0) Google Scholar, 30Towne S.D. Smith M.L. Ory M.G. Geographic variations in access and utilization of cancer screening services: Examining disparities among American Indian and Alaska Native Elders.Int J Health Geogr. 2014; 13: 18Crossref PubMed Scopus (33) Google Scholar Further, rural patients with cancer are underrepresented in research initiatives31Blake K.D. Moss J.L. Gaysynsky A. Srinivasan S. Croyle R.T. Making the case for investment in rural cancer control: An analysis of rural cancer incidence, mortality, and funding trends.Cancer Epidemiol Biomarkers Prev. 2017; 26: 992-997Crossref PubMed Scopus (26) Google Scholar despite highly prevalent socioeconomic, demographic, and environmental risk factors that affect cancer development, treatment, and mortality (eg, tobacco and alcohol abuse, obesity, and lack of insurance).32Bolin J.N. Bellamy G.R. Ferdinand A.O. et al.Rural healthy people 2020: New decade, same challenges.J Rural Health. 2015; 31: 326-333Crossref PubMed Scopus (0) Google Scholar, 33Charlton M. Schlichting J. Chioreso C. Ward M. Vikas P. Challenges of rural cancer care in the United States.Oncology (Williston Park). 2015; 29: 633-640PubMed Google Scholar, 34Jenkins W.D. Matthews A.K. Bailey A. et al.Rural areas are disproportionately impacted by smoking and lung cancer.Prev Med Rep. 2018; 10: 200-203Crossref PubMed Scopus (6) Google Scholar, 35Singh R. Goebel L.J. Rural disparities in cancer care: A review of its implications and possible interventions.W V Med J. 2016; 112: 76-82PubMed Google Scholar Northern Plains American Indians in particular experience among the highest US cancer mortality rates.36Espey D.K. Jim M.A. Cobb N. et al.Leading causes of death and all-cause mortality in American Indians and Alaska Natives.Am J Public Health. 2014; 104: S303-S311Crossref PubMed Scopus (75) Google Scholar Walking Forward (WF) is a multifaceted, National Cancer Institute (NCI)-developed program helmed by a radiation oncology–trained principal investigator (DP). Its goal is to support community cancer centers37Wong R.S.L. Vikram B. Govern F.S. et al.National Cancer Institute’s Cancer Disparities Research Partnership program: Experience and lessons learned.Front Oncol. 2014; 4: 303-310Crossref PubMed Scopus (0) Google Scholar and provide innovation in health care delivery, including comprehensive patient navigation, clinical trial access, and assessment of barriers to earlier diagnosis of screen-detectable cancers.38Petereit D.G. Rogers D. Govern F. et al.Increasing access to clinical cancer trials and emerging technologies for minority populations: The Native American project.J Clin Oncol. 2004; 22: 4452-4455Crossref PubMed Scopus (31) Google Scholar Implementation of Northern Plains American Indian lay patient navigators resulted in improved patient satisfaction and identification of barriers to timely care,39Guadagnolo B.A. Boylan A. Sargent M. et al.Patient navigation for American Indians undergoing cancer treatment: utilization and impact on care delivery in a regional health care center.Cancer. 2011; 117: 2754-2761Crossref PubMed Scopus (32) Google Scholar, 40Guadagnolo B.A. Cina K. Koop D. Brunette D. Petereit D.G. A pre-post survey analysis of satisfaction with health care and medical mistrust after patient navigation for American Indian cancer patients.J Health Care Poor Underserved. 2011; 22: 1331-1343Crossref PubMed Google Scholar, 41Pandhi N. Guadagnolo B.A. Kanekar S. Petereit D.G. Karki C. Smith M.A. Intention to receive cancer screening in Native Americans from the Northern Plains.Cancer Causes Control. 2010; 22: 199-206Crossref PubMed Scopus (2) Google Scholar in turn earning WF cancer screening coordinators access to the Indian Health Service's centers (part of the Department of Health and Human Services). This access facilitated ∼2000 screenings and allowed clinicians and scientists to complete genetic analyses in this highly vulnerable population,42Petereit D. Hahn L.J. Kanekar S. et al.Prevalence of ATM sequence variants in Northern Plains American Indian cancer patients.Front Oncol. 2013; 3: 1-5Crossref PubMed Scopus (2) Google Scholar demonstrating the importance of responsible research that enhances understanding of normal tissue biology and enables future studies by building trust. WF's program is an example of important work to be done in these communities beyond radiation treatment delivery. Our training programs could promote—even incentivize—rural clerkships, similar to what internal medicine programs offer. Creative, radiation oncology–specific solutions could be investigated. ROs are poised to offer pioneering approaches to health care delivery and decode population-based cancer biology. Examples of radiation oncology careers in outcomes and policy exist, but there remains a critical need to engage with health care legislation and economic stakeholders at local, national, and international levels to affect policy decisions involving the complex matrix of cancer care delivery systems. Understanding both the mechanisms affecting the relative costs of radiation oncology procedures and services and the tools used to determine physician performance or adherence to guidelines for reimbursement purposes is a vital skill set. Aside from ROs’ opportunities to influence policy through medical society volunteer activities, another avenue is working with payer organizations either as employees or through grants or contracts to inform new policies. Blue Cross Blue Shield of Michigan supports the Michigan Radiation Oncology Quality Consortium, through which physician leaders have been instrumental in developing programs wherein centers meeting prespecified quality metrics and value-based goals can bypass prior authorization processes and receive increased provider reimbursement. Opportunities also exist within the regulatory space for those with oncology expertise. In fact, the Chief Medical Officer position for the Center for Medicare and Medicaid Innovation is presently occupied by an RO charged with directing development of alternative payment models across medical disciplines. The US Food and Drug Administration (FDA) and the US Nuclear Regulatory Commission also have full- and part-time paid positions specifically for ROs given their unique and crucial perspective and training. Which technologies and devices will be approved and the circumstances in which they can be used is determined by the FDA, clearly affecting fields that use energy sources (eg, ultrasound, hyperthermia) for clinical care. Beyond these specialty-dedicated positions, ROs are qualified for broader full-time positions in these 2 agencies, contributing expertise and gaining experience in cancer drug and equipment development and nuclear regulation. ROs can also participate in policy processes at the global level. The IAEA, serving as the focal point for nuclear cooperation within the United Nations, has a Division of Human Health that employs ROs full-time and is focused on improving access, affordability, and quality in radiation delivery.43Rosenblatt E. Zubizarreta E. Wondergem J. Fidarova E. Izewska J. The International Atomic Energy Agency (IAEA): An active role in the global fight against cancer.Radiother Oncol. 2012; 104: 269-271Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar Nongovernmental organizations provide career-enhancing opportunities to participate in global cancer policy and administration. These organizations include the International Cancer Expert Corps, which focuses on a systems approach to building capacity and capability for LMICs and geographically isolated indigenous populations44International Cancer Expert Corps.https://www.iceccancer.org/Date accessed: October 10, 2018Google Scholar; Radiating Hope, which assists with obtaining radiation equipment for brachytherapy; Chartrounds, which provided case-based education; and the Union for International Cancer Control, which leads advocacy and capacity-building initiatives, collaborating with physicians, policymakers, and patient groups. Policy is often proposed by those in private and academic sectors before the drafting of legislation. Actual policy implementation—and to some extent interpretation—is conducted by those employed within the public sector. Government service offers unique opportunities for translating ROs' knowledge, skills, and abilities into a lever for influencing the health and well-being of individuals on a broad scale. This influence is manifest through a variety of functions, such as managing research programs, informing and interpreting policy decisions, regulating radiation-related pharmaceuticals and equipment, preparing for response to public health emergencies, and educating leaders at all governmental levels. The central theme uniting those who serve government is that public service is a public trust455 CFR 2635.101 - Basic obligation of public service.https://www.gpo.gov/fdsys/granule/CFR-2005-title5-vol3/CFR-2005-title5-vol3-sec2635-101Google Scholar, 465 U.S.C.3331 - Oath of office.https://www.gpo.gov/fdsys/granule/USCODE-2011-title5/USCODE-2011-title5-partIII-subpartB-chap33-subchapII-sec3331/content-detail.htmlGoogle Scholar and offers the satisfaction that arises from knowing one's efforts may affect large segments of the population. US agencies offering unique and interesting opportunities for ROs include the NCI, the National Institute of Allergy and Infectious Diseases, and the Department of Defense. Although advanced degrees like MPH, PharmD, and PhDs are not requisite, ROs with this additional training may better realize the value of these skill sets in the government sector. ROs can participate as team members involved in pharmaceutical countermeasure discovery and development, formulation of clinical practice guidelines and doctrine, radiation and nuclear disaster preparedness and response, and national and international policy decisions. Practitioners wishing to remain closer to clinical medicine may find trials or grants management particularly rewarding given their broad impact and influence. Practically speaking, government careers carry numerous advantages. Many federal agencies allow dedicated time for practice to maintain clinical and technical skills without concerns of revenue generation. Despite the perception of prohibitive income differentials between public and private sectors, certain positions recognize ROs’ competitive salaries and offer relatively generous government compensation and benefits packages along with significant job security. Historically, physicians have not been encouraged to consider careers in industry. Over recent decades, technical advances in radiation therapy treatment planning, imaging, and delivery have led to development of novel techniques such as intensity modulation, image guided therapy, and radiosurgery. These techniques are associated with lower toxicity and greater efficacy; this improved therapeutic ratio has consequently driven expansion of clinical indications for radiation, a demand that is anticipated to build as imaging, treatment delivery, and allied technologies advance in parallel. Compared with other specialties, however, ROs could play a greater role in development of molecularly targeted agents and diagnostics. Innovation in these domains depends on close collaborations with—and possible employment within—industry. Corporate partners can help identify and focus on high-priority needs and have both the ability and relative agility to create, test, commercialize, and rapidly propagate technology. Areas ripe for industry-practitioner projects include improved targeting, application of artificial intelligence, development of radiation-modifying systemic agents, and biomarkers of tissue injury and tumor response. Collaborations can be particularly fruitful when industrial partners have internal competence that helps bridge the gap between business and medicine. Most major radiation oncology technology vendors have “medical affairs” teams because it will become increasingly critical—perhaps mandatory—to formally assess therapeutic improvements in conjunction with increased costs before products can enter routine clinical practice. This domain could be a natural fit for ROs with (or seeking) MBA or JD degrees—an RO phenotype poised for industry leadership. Critical to radiation oncology's growth is a concerted effort to engage similar teams with pharmaceutical companies, focusing on radiation interactions with systemic agents. Our future will be profoundly affected by drug and molecular diagnostics that synergize with radiation and ROs who know how to develop them. Radiation epidemiology (RE) is a collaborative discipline comprising experts in epidemiology, statistics, dosimetry, and radiation medicine investigating the environmental, occupational, and medical and therapeutic effects of radiation on human health.47Boice J.D. Lauriston S. Taylor lecture: Radiation epidemiology—the golden age and future challenges.Health Phys. 2011; 100: 59-76Crossref PubMed Scopus (0) Google Scholar For radiologic and nuclear incidents, including those that are terrorism-related, RE provides a framework of cancer risk and normal tissue injury to help determine the source of injury and means to mitigate acute and late effects.48DiCarlo A.L. Tamarat R. Rios C.I. et al.Cellular therapies for treatment of radiation injury: Report from a NIH/NIAID and IRSN workshop.Radiat Res. 2017; 188: e54-e75Crossref PubMed Scopus (3) Google Scholar, 49Hick J.L. Bader J.L. Coleman C.N. et al.Proposed “Exposure and Symptom Triage” (EAST) tool to assess radiation exposure after a nuclear detonation.Disaster Med Public Health Prep. 2017; 12: 386-395Crossref PubMed Scopus (3) Google Scholar Nuclear detonations and the aftermath of radiophobia have been engrained in the public since 1945. Over the past 30 years, RE has guided design and conduct of major population studies after nuclear power plant accidents like Chernobyl and Fukushima.50Boice J.D. From Chernobyl to Fukushima and beyond—a focus on thyroid cancer.in: Yamashita S. Thomas G. Thyroid Cancer and Nuclear Accidents: Long-Term Aftereffects of Chernobyl and Fukushima. Elsevier, San Diego, CA2017: 21-32Crossref Scopus (0) Google Scholar, 51Boice Jr., J.D. Radiation epidemiology: A perspective on Fukushima.J Radiol Prot. 2012; 32: N33-N40Crossref PubMed Scopus (0) Google Scholar, 52Hasegawa A. Tanigawa K. Ohtsuru A. et" @default.
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• W2945844898 title "Enhancing Career Paths for Tomorrow's Radiation Oncologists" @default.
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