A growing — and aging — population, combined with advances in early detection and treatment, pushed the number of cancer survivors to new heights this year.
More than 18 million Americans with a history of cancer, two-thirds of them over the age of 65 years, were living in the U.S. as of January 1 of this year, according to Kimberly Miller, MPH, of the American Cancer Society, and colleagues.
That number, already over a million more than in 2019, is expected to grow: Over 200,000 new diagnoses each of breast cancer and lung cancer are estimated for 2022, the authors reported in a paper published in CA: A Cancer Journal for Clinicians.
“As the population of cancer survivors continues to grow and age, there is an increased need for guidance for health professionals, caregivers, and patients on how to manage late and long-term effects of cancer and its treatment, maintain healthy behaviors and limit financial toxicity,” Miller said in a press release.
“In addition, the survivor population is increasingly diverse, and further resources are needed to ensure equitable access to survivorship care,” she said.
Her group had found that for most cancers, adjusted 5-year cancer survival rates were lower for Black patients compared with white patients.
In the case of urinary bladder cancer, for example, 5-year survival was just 65% for Black patients after adjustment for normal life expectancy, compared with 78% for white peers. And in the case of uterine corpus cancer, 5-year survival ranged from 63% for Black women to 84% for white women.
Miller and colleagues highlighted pervasive disparities in access to treatment. They illustrated this with the finding that Black women tended to have a higher burden of aggressive tumor subtypes, were less likely to be diagnosed with stage I disease, and had lower survival rates regardless of histology or stage.
“Despite increasing awareness of survivorship issues and the resilience of cancer survivors, many challenges remain,” the authors concluded.
“These include a fractured health care system, poor integration of survivorship care between oncology and primary care settings, clinician workforce shortages, lack of diversity in the medical workforce, knowledge gaps about the needs of cancer survivors, and lack of strong evidence-based guidelines for post-treatment care,” they said.
Cancer prevalence estimates were model-based projections based on population-based data current as of Jan. 1, 2022. The data were sourced from the Surveillance, Epidemiology, and End Results Program; the National Center for Health Statistics; and U.S. Census Bureau population estimates through 2018.
There were 8.3 million male survivors and 9.7 female survivors in the report. The most prevalent cancers for men were prostate, melanoma, and colorectal cancer. For women, breast, uterine, and thyroid cancer were most prevalent.
Miller’s group determined that a majority of cancer survivors (53%) had been diagnosed within the last 10 years, with 18% having been diagnosed 20 or more years ago.
Survivor estimates in the report did not account for the potential impact of COVID-19, nor did they distinguish between individuals living disease-free and those in active treatment, the authors cautioned.
Disclosures
Miller and several co-authors reported they are employed by the American Cancer Society, which receives grants from private and corporate foundations, including foundations associated with companies in the health sector for research outside of the submitted work.
One coauthor serves on the Flatiron Health Equity advisory board and receives honoraria paid to her institution.
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