Cancer Survivors in the United States: Prevalence across the Survivorship Trajectory and Implications for Care

Background: Cancer survivors represent a growing population, heterogeneous in their need for medical care, psychosocial support, and practical assistance. To inform survivorship research and practice, this manuscript will describe the prevalent population of cancer survivors in terms of overall numbers and prevalence by cancer site and time since diagnosis. Methods: Incidence and survival data from 1975–2007 were obtained from the Surveillance, Epidemiology, and End Results Program and population projections from the United States Census Bureau. Cancer prevalence for 2012 and beyond was estimated using the Prevalence Incidence Approach Model, assuming constant future incidence and survival trends but dynamic projections of the U.S. population. Results: As of January 1, 2012, approximately 13.7 million cancer survivors were living in the United States with prevalence projected to approach 18 million by 2022. Sixty-four percent of this population have survived 5 years or more; 40% have survived 10 years or more; and 15% have survived 20 years or more after diagnosis. Over the next decade, the number of people who have lived 5 years or more after their cancer diagnosis is projected to increase approximately 37% to 11.9 million. Conclusions: A coordinated agenda for research and practice is needed to address cancer survivors' long-term medical, psychosocial, and practical needs across the survivorship trajectory. Impact: Prevalence estimates for cancer survivors across the survivorship trajectory will inform the national research agenda as well as future projections about the health service needs of this population. Cancer Epidemiol Biomarkers Prev; 22(4); 561–70. ©2013 AACR.

[1]  A. Stanton What happens now? Psychosocial care for cancer survivors after medical treatment completion. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  Alona Muzikansky,et al.  Early palliative care for patients with metastatic non-small-cell lung cancer. , 2010, The New England journal of medicine.

[3]  K. Oeffinger,et al.  Models for delivering survivorship care. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  P. Ganz,et al.  Impact of Survivorship-Based Research on Defining Clinical Care Guidelines , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[5]  J. Rowland,et al.  Recovery issues in cancer survivorship: a new challenge for supportive care. , 2006, Cancer journal.

[6]  M. Arantzamendi,et al.  The psychosocial impact of recurrence on cancer survivors and family members: a narrative review. , 2009, Journal of advanced nursing.

[7]  Suanna S Bruinooge,et al.  Future supply and demand for oncologists : challenges to assuring access to oncology services. , 2007, Journal of oncology practice.

[8]  Thomas J. Smith,et al.  The shortage of essential chemotherapy drugs in the United States. , 2011, The New England journal of medicine.

[9]  G. Colditz,et al.  The persistent impact of breast carcinoma on functional health status , 2000, Cancer.

[10]  V. Helgeson,et al.  Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. , 2010, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[11]  Jiaquan Xu,et al.  Deaths: final data for 2008. , 2011, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[12]  Angela B Mariotto,et al.  Cancer Survivors: A Booming Population , 2011, Cancer Epidemiology, Biomarkers & Prevention.

[13]  Charles C. Hinnant,et al.  Exploring digital divides: An examination of eHealth technology use in health information seeking, communication and personal health information management in the USA , 2011, Health Informatics J..

[14]  K. Robien,et al.  Quality of life in a prospective cohort of elderly women with and without cancer , 2009, Cancer.

[15]  Hu Shih,et al.  Development of Methodology , 1980 .

[16]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[17]  Rascon [The National Cancer Institute]. , 1953, Boletin cultural e informativo - Consejo General de Colegios Medicos de Espana.

[18]  C. Earle,et al.  Models of care for post-treatment follow-up of adult cancer survivors: a systematic review and quality appraisal of the evidence , 2012, Journal of Cancer Survivorship.

[19]  Martin Krapcho,et al.  SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations) , 2012 .

[20]  Patricia A. Ganz,et al.  From cancer patient to cancer survivor : lost in transition , 2006 .

[21]  John R. Moran,et al.  Medical expenditures of adult cancer survivors aged <65 years in the United States , 2011, Cancer.

[22]  Cornelia M. Ruland,et al.  Effects of a computer-supported interactive tailored patient assessment tool on patient care, symptom distress, and patients' need for symptom management support: a randomized clinical trial , 2010, J. Am. Medical Informatics Assoc..

[23]  S. Fosså,et al.  Long term physical sequelae after adult-onset cancer , 2008, Journal of cancer survivorship : research and practice.

[24]  Gordon H. Sun The Digital Divide in Internet-Based Patient Education Materials , 2012, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[25]  M. Diefenbach,et al.  Cancer survivorship and aging , 2008, Cancer.

[26]  E. Feuer,et al.  Projecting the number of patients with colorectal carcinoma by phases of care in the US: 2000–2020 , 2006, Cancer Causes & Control.

[27]  Eric J Feuer,et al.  Projections of the cost of cancer care in the United States: 2010-2020. , 2011, Journal of the National Cancer Institute.

[28]  M. Hertzog,et al.  Usual and worst symptom severity and interference with function in breast cancer survivors. , 2012, The journal of supportive oncology.

[29]  R. Yancik,et al.  Cancer survivors in the United States: age, health, and disability. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[30]  J. Lubitz,et al.  Long-term trends in Medicare payments in the last year of life. , 2010, Health services research.

[31]  M. Denniston,et al.  Change in health‐related quality of life of newly diagnosed cancer patients, cancer survivors, and controls * , 2009, Cancer.

[32]  A. Odén,et al.  Experience and predictors of symptoms, distress and health‐related quality of life over time in postmenopausal women with recurrent breast cancer , 2008, Psycho-oncology.

[33]  A. Jemal,et al.  Cancer statistics, 2012 , 2012, CA: a cancer journal for clinicians.

[34]  S. Lutgendorf,et al.  Adjusting to life after treatment: distress and quality of life following treatment for breast cancer , 2007, British Journal of Cancer.

[35]  J. Maher,et al.  The National Cancer Survivorship Initiative: new and emerging evidence on the ongoing needs of cancer survivors , 2011, British Journal of Cancer.

[36]  John Glaser HITECH lays the foundation for more ambitious outcomes-based reimbursement. , 2010, The American journal of managed care.

[37]  E. Watson,et al.  Personalised cancer follow-up: risk stratification, needs assessment or both? , 2012, British Journal of Cancer.

[38]  R. Heist,et al.  Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[39]  R. Hays,et al.  Impact of cancer on health-related quality of life of older Americans. , 2009, Journal of the National Cancer Institute.

[40]  W. Lawrence,et al.  Health Limitations and Quality of Life Associated With Cancer and Other Chronic Diseases by Phase of Care , 2007, Medical care.

[41]  R. Capocaccia,et al.  Estimation and projections of cancer prevalence from cancer registry data , 2002, Statistics in medicine.

[42]  M. Andrykowski Physical and mental health status of survivors of multiple cancer diagnoses , 2012, Cancer.

[43]  Bradford W Hesse,et al.  What Do People Affected by Cancer Think About Electronic Health Information Exchange? Results From the 2010 LIVESTRONG Electronic Health Information Exchange Survey and the 2008 Health Information National Trends Survey. , 2011, Journal of oncology practice.

[44]  Suzanne Pingree,et al.  Optimizing eHealth breast cancer interventions: which types of eHealth services are effective? , 2011, Translational behavioral medicine.

[45]  C. Ulrich,et al.  Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. , 2013, Journal of the National Cancer Institute.

[46]  Jalpa A Doshi,et al.  Long-term risk for depressive symptoms after a medical diagnosis. , 2005, Archives of internal medicine.

[47]  Misha Pavel,et al.  Advancing the Science of mHealth , 2012, Journal of health communication.

[48]  B. Chabner,et al.  Drug shortages--a critical challenge for the generic-drug market. , 2011, The New England journal of medicine.

[49]  Angela Mariotto,et al.  Cost of care for elderly cancer patients in the United States. , 2008, Journal of the National Cancer Institute.

[50]  A. Shad,et al.  Late Effects in Cancer Survivors: “The Shared Care Model” , 2012, Current Oncology Reports.

[51]  Suzanne Pingree,et al.  Internet-Based Interactive Support for Cancer Patients: Are Integrated Systems Better? , 2008, The Journal of communication.

[52]  Qiuling Shi,et al.  Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.