Cancer treatment and survivorship statistics, 2022 Miller, Kimberly D.; Nogueira, Leticia; Devasia, Theresa ...
CA: a cancer journal for clinicians,
September/October 2022, Letnik:
72, Številka:
5
Journal Article
Recenzirano
Odprti dostop
The number of cancer survivors continues to increase in the United States due to the growth and aging of the population as well as advances in early detection and treatment. To assist the public ...health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries, vital statistics from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Database are presented for the most prevalent cancer types by race, and cancer‐related and treatment‐related side‐effects are also briefly described. More than 18 million Americans (8.3 million males and 9.7 million females) with a history of cancer were alive on January 1, 2022. The 3 most prevalent cancers are prostate (3,523,230), melanoma of the skin (760,640), and colon and rectum (726,450) among males and breast (4,055,770), uterine corpus (891,560), and thyroid (823,800) among females. More than one‐half (53%) of survivors were diagnosed within the past 10 years, and two‐thirds (67%) were aged 65 years or older. One of the largest racial disparities in treatment is for rectal cancer, for which 41% of Black patients with stage I disease receive proctectomy or proctocolectomy compared to 66% of White patients. Surgical receipt is also substantially lower among Black patients with non‐small cell lung cancer, 49% for stages I‐II and 16% for stage III versus 55% and 22% for White patients, respectively. These treatment disparities are exacerbated by the fact that Black patients continue to be less likely to be diagnosed with stage I disease than White patients for most cancers, with some of the largest disparities for female breast (53% vs 68%) and endometrial (59% vs 73%). Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence‐based strategies and equitable access to available resources are needed to mitigate disparities for communities of color and optimize care for people with a history of cancer. CA Cancer J Clin. 2022;72:409‐436.
Distant metastatic breast cancer (MBC), including metastases found at diagnosis (
) and those occurring later (recurrence), represents the most severe form of the disease, when resource utilization ...is most intensive. Yet, the number of women living with MBC in the United States is unknown. The objective of this article is to use population-based data to estimate the prevalence of MBC.
We used a back-calculation method to estimate MBC prevalence from U.S. breast cancer mortality and survival from the Surveillance, Epidemiology and End Results (SEER) registries. On the basis of the illness-death process, this method assumes that each observed breast cancer death is the result of MBC, either
or a recurrence with metastatic disease.
We estimate that by January 1, 2017, there will be 154,794 women living with MBC in the United States, three in four initially diagnosed with stage I-III breast cancer who later progressed to MBC.Median survival and 5-year relative survival for
MBC increased over the years, especially in younger women. We estimate a two-fold increase in 5-year relative survival rate from 18% to 36%, for women diagnosed with
MBC at age 15-49 between 1992-1994 and 2005-2012, respectively.
This study demonstrates an increasing number of women in the United States living with MBC, likely the result of improvements in treatment and aging of the U.S.
The increasing burden of MBC highlights the importance of documenting recurrence to foster more research into the specific needs of this understudied population.
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Lung-cancer incidence has been decreasing in part because of a decrease in smoking. However, the decline in population-based mortality from non–small-cell lung cancer has been greater than can be ...accounted for by cancer screening and a decrease in cancer incidence. Evidence indicates that advances in treatment account for the acceleration in decreased mortality.
Cancer treatment and survivorship statistics, 2019 Miller, Kimberly D.; Nogueira, Leticia; Mariotto, Angela B. ...
CA: a cancer journal for clinicians,
September/October 2019, Letnik:
69, Številka:
5
Journal Article
Recenzirano
Odprti dostop
The number of cancer survivors continues to increase in the United States because of the growth and aging of the population as well as advances in early detection and treatment. To assist the public ...health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate every 3 years to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries; vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics; and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Data Base are presented for the most prevalent cancer types. Cancer‐related and treatment‐related short‐term, long‐term, and late health effects are also briefly described. More than 16.9 million Americans (8.1 million males and 8.8 million females) with a history of cancer were alive on January 1, 2019; this number is projected to reach more than 22.1 million by January 1, 2030 based on the growth and aging of the population alone. The 3 most prevalent cancers in 2019 are prostate (3,650,030), colon and rectum (776,120), and melanoma of the skin (684,470) among males, and breast (3,861,520), uterine corpus (807,860), and colon and rectum (768,650) among females. More than one‐half (56%) of survivors were diagnosed within the past 10 years, and almost two‐thirds (64%) are aged 65 years or older. People with a history of cancer have unique medical and psychosocial needs that require proactive assessment and management by follow‐up care providers. Although there are growing numbers of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence‐based resources are needed to optimize care.
Cancer treatment and survivorship statistics, 2016 Miller, Kimberly D.; Siegel, Rebecca L.; Lin, Chun Chieh ...
CA: a cancer journal for clinicians,
July/August 2016, Letnik:
66, Številka:
4
Journal Article
The prevalence of cancer survivorship is increasing. In this study, we provide contemporary population-based estimates and projections of the overall and site-specific cancer-attributable medical ...care costs in the United States.
We identified survivors aged ≥65 years diagnosed with cancer between 2000 and 2012 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and used 2007 to 2013 claims to estimate costs by cancer site, phases of care, and stage at diagnosis. Annualized average cancer-attributable costs for medical care (Medicare Parts A and B) and oral prescription drugs (Medicare Part D) were estimated by subtracting costs between patients with cancer and matched controls. Costs are reported in 2019 U.S. dollars. We combined phase-specific attributable costs with prevalence projections to estimate national costs from 2015 through 2030.
Overall annualized average costs were highest in the end-of-life-cancer death phase, followed by the initial and continuing phases (medical care: $105,500, $41,800, and $5,300 and oral prescription drugs: $4,200, $1,800, $1,100, respectively). There was considerable variation in costs by cancer site and stage. Overall national costs in 2015 were $183 billion and projected to increase 34% to $246 billion by 2030, based only on population growth.
Phase of care cancer-attributable cost estimates by cancer site and stage are key inputs for simulation models and cost-effectiveness analyses.
The national cancer-attributed medical care costs in the United States are substantial and projected to increase dramatically by 2030, due to population changes alone, reflecting the rising burden of cancer care among cancer survivors.
Cancer treatment and survivorship statistics, 2014 DeSantis, Carol E.; Lin, Chun Chieh; Mariotto, Angela B. ...
CA: a cancer journal for clinicians,
July/August 2014, Letnik:
64, Številka:
4
Journal Article
Many guidelines recommend considering health status and life expectancy when making cancer screening decisions for elderly persons.
To estimate life expectancy for elderly persons without a history ...of cancer, taking into account comorbid conditions.
Population-based cohort study.
A 5% sample of Medicare beneficiaries in selected geographic areas, including their claims and vital status information.
Medicare beneficiaries aged 66 years or older between 1992 and 2005 without a history of cancer (n = 407 749).
Medicare claims were used to identify comorbid conditions included in the Charlson index. Survival probabilities were estimated by comorbidity group (no, low/medium, and high) and for the 3 most prevalent conditions (diabetes, chronic obstructive pulmonary disease, and congestive heart failure) by using the Cox proportional hazards model. Comorbidity-adjusted life expectancy was calculated based on comparisons of survival models with U.S. life tables. Survival probabilities from the U.S. life tables providing the most similar survival experience to the cohort of interest were used.
Persons with higher levels of comorbidity had shorter life expectancies, whereas those with no comorbid conditions, including very elderly persons, had favorable life expectancies relative to an average person of the same chronological age. The estimated life expectancy at age 75 years was approximately 3 years longer for persons with no comorbid conditions and approximately 3 years shorter for those with high comorbidity relative to the average U.S. population.
The cohort was limited to Medicare fee-for-service beneficiaries aged 66 years or older living in selected geographic areas. Data from the Surveillance, Epidemiology, and End Results cancer registry and Medicare claims lack information on functional status and severity of comorbidity, which might influence life expectancy in elderly persons.
Life expectancy varies considerably by comorbidity status in elderly persons. Comorbidity-adjusted life expectancy may help physicians tailor recommendations for stopping or continuing cancer screening for individual patients.
Current estimates of the costs of cancer care in the United States are based on data from 2003 and earlier. However, incidence, survival, and practice patterns have been changing for the majority of ...cancers.
Cancer prevalence was estimated and projected by phase of care (initial year following diagnosis, continuing, and last year of life) and tumor site for 13 cancers in men and 16 cancers in women through 2020. Cancer prevalence was calculated from cancer incidence and survival models estimated from Surveillance, Epidemiology, and End Results (SEER) Program data. Annualized net costs were estimated from recent SEER-Medicare linkage data, which included claims through 2006 among beneficiaries aged 65 years and older with a cancer diagnosis. Control subjects without cancer were identified from a 5% random sample of all Medicare beneficiaries residing in the SEER areas to adjust for expenditures not related to cancer. All cost estimates were adjusted to 2010 dollars. Different scenarios for assumptions about future trends in incidence, survival, and cost were assessed with sensitivity analysis.
Assuming constant incidence, survival, and cost, we projected 13.8 and 18.1 million cancer survivors in 2010 and 2020, respectively, with associated costs of cancer care of 124.57 and 157.77 billion 2010 US dollars. This 27% increase in medical costs reflects US population changes only. The largest increases were in the continuing phase of care for prostate cancer (42%) and female breast cancer (32%). Projections of current trends in incidence (declining) and survival (increasing) had small effects on 2020 estimates. However, if costs of care increase annually by 2% in the initial and last year of life phases of care, the total cost in 2020 is projected to be $173 billion, which represents a 39% increase from 2010.
The national cost of cancer care is substantial and expected to increase because of population changes alone. Our findings have implications for policy makers in planning and allocation of resources.
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