Sustaining Canada's cancer workforce: A pan-Canadian review of innovations in the rising needs for equitable care.

BACKGROUND: Cancer care systems globally are facing a growing crisis driven by rising cancer incidence, increasing clinical and social complexity, persistent inequities in access to specialized services, and mounting pressures on the oncology workforce. While innovations in technology and team-based care offer opportunities to improve access, coordination, and outcomes, their scalability depends on strengthening oncology workforce capacity. OBJECTIVE: This study examined how five high-impact innovation domains in Canada can be enabled and scaled through strengthening oncology workforce capacity, and organizational and policy enablers. METHODS: A mixed-methods synthesis was conducted, including (i) a structured synthesis of peer-reviewed systematic reviews reporting implemented cancer care innovations; (ii) targeted analysis of Canadian and international policy and program reports addressing post-pandemic cancer reforms; and (iii) pan-Canadian stakeholder engagement with clinical, operational, and policy leaders to validate exemplars, constraints, and implementation considerations. Findings were analyzed using the Consolidated Framework for Implementation Research (CFIR), with particular attention to workforce capacity, distribution, and sustainability. RESULTS: Five innovation categories emerged as priorities for Canada: virtual care, AI applications, team-based care, expanded clinical roles, and community-based services. Across all evidence streams, the dominant constraint to scale was misalignment between innovations and oncology workforce planning, regulation, competencies, and funding. Innovations achieved greater impact when accompanied by workforce redesign, role optimization, targeted capacity building, and retention. CONCLUSIONS: Strengthening Canada's oncology workforce is a national priority with important implications for advancing cancer equity, with potential applicability to other health systems facing similar challenges.