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The growth and aging of the population combined with advances in the early detection and treatment of cancer have resulted in a growing population of survivors across the nation, according to a study from the American Cancer Society and the National Cancer Institute.
The growth and aging of the population combined with advances in the early detection and treatment of cancer have resulted in a growing population of survivors across the nation, according to a study from the American Cancer Society and the National Cancer Institute. In addition, cancer rates are declining in men and stabilizing in women. The report indicates that more than 16.9 million Americans with a history of cancer were alive as of January 1, 2019. It projects that this number will surpass 22.1 million by 2030. The majority of cancer survivors are ≥65 years and were given a diagnosis within the past decade, the study said (Figure).
Among women, breast cancer is the most prevalent cancer type, with 268,600 new cases expected this year. The number of US women with a history of invasive breast cancer currently exceeds 3.8 million, and more than 150,000 live with metastatic disease. The large pool of breast cancer survivors is partly due to the rising 5-year relative survival rate, which grew from 79% for patients whose disease was diagnosed between 1984 and 1986 to 91% for those with diagnoses between 2008 and 2014. Approximately 64% (>2.4 million) of survivors are ≥65 years; 7% are <50 years.
With 3,650,030 survivors as of January 1, 2019, prostate cancer is the most prominent cancer in men. The 5-year relative survival rate increased from 83% in the late 1980s to 99% from 2008 to 2014. Similarly, survival rates for acute lymphoblastic leukemia (ALL) have increased over the past 3 decades, particularly among pediatric patients. More than 95% of the pediatric population with ALL achieves remission, compared with 78% to 92% of adults. In the early 1980s, a 16 percentage point difference (55% vs 71%) marked the survival disparity between black and white children and adolescents. That narrowed to an 8 percentage point difference (85% vs 93%) between 2008 and 2014.
Lung cancer and testicular cancer survival rates also have increased. The rate of the former rose from 34% for patients whose disease was diagnosed between 1975 and 1977 to 47% for those with diagnoses from 2011 to 2014. Authors of the report attributed this improvement to surgical and chemoradiation advances. After charting a continuous increase since the mid-1970s, the 5-year relative survival for testicular cancer is now 99%, thanks to the efficacy of chemotherapy regimens for advanced disease.
Investigators said poor integration of survivorship care between the oncology and primary care settings, clinician workforce shortages, and insufficient knowledge about the needs of cancer survivors are some of the challenges that remain in this setting.
Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019 [published online June 11, 2019]. CA Cancer J Clin. doi: 10.3322/caac.21565.