The histopathology workforce is a cornerstone of cancer diagnostics and is essential to the delivery of cancer services and patient care. The workforce has been subject to significant pressures over recent years, and this review considers them in the UK and internationally. These pressures include declining pathologist numbers, the increasing age of the workforce, and greater workload volume and complexity. Forecasts of the workforce's future in numerous countries are also not favourable - although this is not universal. Some in the field suggest that the effects of these pressures are already coming to bear, such as the financial costs of the additional measures needed to maintain clinical services. There is also some evidence of a detrimental impact on service delivery, patient care and pathologists themselves. Various solutions have been considered, including increasing the number of training places, enhancing recruitment, shortening pathology training and establishing additional support roles within pathology departments. A few studies have examined the effect of some of these solutions. However, the broader extent of their implementation and impact, if any, remains to be determined. In this regard, it is critical that future endeavours should focus on gaining a better understanding of the benefits of implemented workforce solutions, as well as obtaining more detailed and updated pathology workforce numbers. With a concentrated effort in these areas, the future of the pathology workforce could become brighter in the face of the increased demands on its services.
