Cancer Survivors: A Booming Population

Office of Cancer Survivorship, National Cancer Institute, NIH, Bethesda, MD 20892, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 10/2011; 20(10):1996-2005. DOI: 10.1158/1055-9965.EPI-11-0729
Source: PubMed


In this first article of what is planned to be an annual series, we examine the history of cancer prevalence reporting and the role that these annual figures play in guiding the direction of cancer control research, and specifically the science of cancer survivorship. For this inaugural year, we focus on the confluence of the growing number of survivors and population aging, and the impact these combined trends will have on cancer survivorship in the future.
State or metro area-level cancer incidence and prevalence data were collected from 9 registries via the Surveillance, Epidemiology, and End Results Program. The complete prevalence method was used to estimate prevalence for 2008 and the Prevalence, Incidence Approach Model method was used to project prevalence data through 2020, assuming flat cancer incidence and survival trends but dynamic U.S. population projections.
As of January 2008, the number of cancer survivors is estimated at 11.9 million. Approximately 60% of cancer survivors are age 65 or older, and by the year 2020, it is estimated that 63% of cancer survivors will be age 65 or older.
Improved survival and population aging converge to generate a booming population of older adult cancer survivors, many of whom have multiple complex health conditions and unique survivorship needs. This demographic shift has important implications for future health care needs and costs of the U.S. population.
The findings provide information critical for guiding cancer prevention and control research and service provision.

Download full-text


Available from: Julia Rowland,
  • Source
    • "Cancer survivors are at greater risk of developing second primary cancer (SPC) as well as other diseases [1]. With improvements of cancer survival due to more frequent early detection and advances in cancer treatments, the cancer survivor population continues to grow, reaching an estimated 28.8 million 5-year survivors worldwide [2], surpassing one million in France [2], while the complete US cancer prevalence was estimated to be 11.9 million in 2008 [3]. Although large population-based studies using cancer registries data have been carried out in the US, Italy, Sweden, Switzerland, Australia, England and Wales, Denmark, Finland and Japan to assess the risk of SPC detailed by site of first primary cancer [4-14], SPC incidence estimates in France are thus far lacking. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk. Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site. Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up. French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.
    BMC Cancer 02/2014; 14(1):94. DOI:10.1186/1471-2407-14-94 · 3.36 Impact Factor
  • Source
    • "One exception was that older survivors more frequently indicated debt concerns (see (Rogers, Harvey-Woodworth, Hare, Leong, & Lowe, 2012) for an example of older survivors reporting fewer financial concerns). Older survivors (age 65 and up) are an understudied group, and addressing their post-treatment concerns, including economic concerns that may be more challenging in the context of retirement compared to survivors who are working, is a high priority (Bellury et al., 2011; Parry, Kent, Mariotto, Alfano, & Rowland, 2011). Respondents who received the most treatment (chemotherapy plus surgery and/or radiation) consistently fared worse compared to respondents who received less treatment. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Unlabelled: There is a need to better understand the posttreatment concerns of the nearly 14 million survivors of cancer alive in the United States today and their receipt of care. Using data from 2,910 posttreatment survivors of cancer from the 2006 or 2010 LIVESTRONG Surveys, the authors examined physical, emotional, and practical concerns, receipt of care, and trends in these outcomes at the population level. Results: 89% of respondents reported at least one physical concern (67% received associated posttreatment care), 90% reported at least one emotional concern (47% received care), and 45% reported at least one practical concern (36% received care). Female survivors, younger survivors, those who received more intensive treatment, and survivors without health insurance often reported a higher burden of posttreatment concerns though were less likely to have received posttreatment care. These results reinforce the importance of posttreatment survivorship and underscore the need for continued progress in meeting the needs of this population. Efforts to increase the availability of survivorship care are extremely important to improve the chances of people affected by cancer living as well as possible in the posttreatment period.
    Journal of Psychosocial Oncology 12/2013; 32(2). DOI:10.1080/07347332.2013.874004 · 1.04 Impact Factor
  • Source
    • "According to our results, the proportion of cancer survivors has increased over time, which is consistent with data from the Behavioral Risk Factor Surveillance Survey (BRFSS) [5] and NCI's Surveillance, Epidemiology, and End Results (SEER) [2] [3]. This growth is generally attributed to an aging population and longer survival due to implementation of effective screening tests, earlier stage at diagnosis, and better treatments [12]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: . Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods . To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results . The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (
    06/2013; 2013(9):238017. DOI:10.1155/2013/238017
Show more