Oncology Metrics, a division of Altos Solutions, has been conducting organized surveys of practicing oncologists since 2005. In this article, we present data that represent trends in community oncology practice over a 6-year period, 2005 to 2010, and make projections on the basis of these data. Over the next 3 years, operating margins will continue to decrease, gains in business and clinical operating efficiencies will slow, and labor costs will rise. The cost of drugs provided to patients is also increasing while the amount above cost that is being reimbursed continues a slow decline. The gap between practice costs and practice revenue will continue to narrow, and as this occurs, community oncology practices will find it difficult to maintain their current business models.