Cancer Survivorship in the United States from 1971 to 2001
To highlight how the population of cancer survivors has changed in the United States, the National Cancer Institute and CDC studied cancer data collected during 1971--2001. This report summarizes the results of that study, which determined that the number of persons living with cancer increased from 3.0 million (1.5% of the U.S. population) in 1971 to 9.8 million (3.5%) in 2001.
A national health objective for 2010 is to increase to 70% the proportion of cancer patients who are living >5 years after diagnosis (objective no. 3-15), an objective already achieved for children with cancer but not yet for adults.
The growing number of persons living with cancer poses challenges for researchers to understand the physical, psychosocial, and economic effects of surviving cancer and for public health practitioners to develop evidence-based programs to promote the health and well-being of cancer survivors.
This report uses incidence and follow-up data from registries in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute to estimate the number of persons alive after a diagnosis of cancer and to monitor the progress in cancer survivorship (3).
In addition, survival rates for persons receiving a diagnosis of cancer during 1991--2000 were compared with those receiving a cancer diagnosis during 1974--1976, the earliest dates for which SEER maintained data on survival; data collection for SEER began on January 1, 1973.
To overcome the limited duration of data collection in all but the Connecticut registry (which began collecting data in 1935), estimates were adjusted to obtain lifetime or complete counts by using a statistical model that accounts for cases diagnosed before the start of the SEER program (4).
The estimated number of cancer survivors was calculated by using data from SEER-9 registries to estimate the proportion of persons, by age, sex, and race, who were alive on January 1, 2001, and had a diagnosis of cancer during 1975--2000, taking into account loss to follow-up (4). These estimates were projected to U.S. population estimates, and data for all races combined were estimated by summing the counts for whites/unknown, blacks, and other races (5).
Finally, the number of persons with a diagnosis of cancer no matter how long since the diagnosis was 1) estimated by adjusting the limited-duration data based on statistical modeling of incidence and survival, controlling for age and sex (6), and 2) validated by using 1940--1997 data from the historical Connecticut registry.
For all cancers combined, the number of survivors in the United States has increased steadily during the last three decades. In 1971, an estimated 3.0 million persons were living with cancer, representing approximately 1.5% of the population. In 2001, an estimated 9.8 million persons were cancer survivors, approximately 3.5% of the population (Figure 1).
In the absence of other competing causes of death, an estimated 64% of adults whose cancer was diagnosed during 1995--2000 could expect to be alive 5 years after diagnosis, compared with 50% for those whose cancer was diagnosed during 1974--1976. Among children (i.e., persons aged 5 years after diagnosis during 1974--1976.
Among all cancer survivors in 2001, an estimated 14% had received a cancer diagnosis >20 years ago (Figure 2). More females than males were survivors, although more males than females received cancer diagnoses. In 2001, men had a higher proportion of lung cancer, for which survival chances are poor, whereas women had higher proportions of more readily detectable and treatable cancers (e.g., breast and gynecologic).
Among cancer survivors in 2001, the most common primary cancer type was female breast cancer (22%), followed by prostate cancer (17%), colorectal cancer (11%), and gynecologic cancer (10%) (Figure 3). In 2001, an estimated 60% of all newly diagnosed cancers occurred among persons aged >65 years, who represented 61% of all cancer survivors. Thirty-three percent of cancer survivors were aged 40--64 years, 5% were aged 20--39 years, and
Survivorship de Cancer din Statele Unite din 1971 pânã în 2001 - Cancer Survivorship in the United States from 1971 to 2001 - articole medicale engleza - startsanatate