One in sixteen people in the U.S. will be a cancer survivor by 2030, according to a new report by the American Cancer Society and the National Cancer Institute. The Cancer treatment and survivorship statistics, 2019 report, states that the numbers will soar from 16.9 million Americans with a history of cancer as of the 1st of January this year to 22.1 million just over a decade from now. 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 and Survivorship in 2019: A Look at the Numbers
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.
Although cancer incidence rates are stable in women and slightly declining in men, new advances in treatments such as targeted therapies and better early screening and diagnostic techniques mean more people are surviving their disease, with around 50% of people now expected to survive ten years or more after diagnosis. The report cites two-thirds of cancer survivors are over 65 and on the other end of the age spectrum, the report estimates that in the U.S., there are 65,850 cancer survivors 14 years and under and 47,760 ages 15 to 19.
A growing number of people surviving cancer is undoubtedly good news, however, it is becoming increasingly well-known that those who have had cancer can experience a wide range of long-term side-effects, affecting both physical and mental health as a result of their treatment. These, combined with the high costs of cancer treatment leaving many survivors with financial issues means that for many people, cancer can have life-long impact.
“People with a history of cancer have unique medical, psychosocial, and economic needs that require proactive assessment and management by health care providers,” said Robin Yabroff, Ph.D., senior scientific director of Health Services Research and co-author of the report.
It is universally accepted that the needs of cancer survivors are not currently being met. For a long time, the sole focus of cancer research as a field was to successfully treat as many people as possible, with only minimal regard as to what happened to them in the long-term. This, thankfully is slowly changing and more research projects identifying the needs of cancer survivors and intervening to help them, are coming to fruition, but much more is needed.
Another big question is how the U.S. healthcare system is going to manage to look after this vast number of cancer survivors. Many survivors continue to see their oncologists for long-term side effects that are not related to cancer recurrence or secondary cancers as there is simply no better person to go to. This means that oncology departments, too, are becoming overwhelmed as they try to manage both new patients and those who have finished treatment.
“The system for caring for cancer survivors in the U.S. we have currently is not sustainable. We have more survivors and they are living longer, which is, of course, wonderful, but healthcare systems are not currently set up to care for a large and increasing number of survivors,” said Dr Corrine Leach, PhD, Strategic Director of Cancer and Aging Research at the American Cancer Society, quoted last year in this Forbes Health article.
Cancer population is outpacing available oncologists
New models of cancer survivorship care delivery are urgently needed, say Deborah Mayer, PhD, RN, director of cancer survivorship, University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill and Catherine Alfano, PhD, vice president of survivorship, American Cancer Society, Washington, D.C..
In the United States, the combination of an aging population, a “tsunami” of cancer survivors, and a projected 10% shortfall in the oncologist workforce by 2025 is putting quality cancer follow-up care in serious jeopardy, according to experts.
The pair say that “…a confluence of shifting factors is creating a perfect storm that means ‘business as usual’ for US health-care systems will increasingly be unable to deliver post-treatment follow-up care for cancer survivors that meet their needs.” Providing the best possible follow-up care for cancer survivors in the most appropriate setting “will reduce demand pressures on oncology practices by allowing the cancer specialists to focus on those who are most in need of their expertise,” said Mayer in a statement.
These factors create a compelling need to provide coordinated, comprehensive, personalized care for cancer survivors in ways that meet survivors’ and caregivers’ unique needs while minimizing the impact of provider shortages and controlling costs for health care systems, survivors, and families. In the article A Blueprint for Cancer Survivorship, the authors reviewed research identifying and addressing the needs of cancer survivors and caregivers and used this synthesis to create a set of critical priorities for care delivery, research, education, and policy to equitably improve survivor outcomes and support caregivers.
Efforts are needed in 3 priority areas:
- implementing routine assessment of survivors’ needs and functioning and caregivers’ needs;
- facilitating personalized, tailored, information and referrals from diagnosis onward for both survivors and caregivers, shifting services from point of care to point of need wherever possible;
- and disseminating and supporting the implementation of new care methods and interventions.