Surviving Cancer: US Numbers Are Estimated at Nearly 18 Million by 2022

Abstract

Although there has been considerable progress in reducing cancer incidence in the United States, the number of cancer survivors continues to increase due to the aging and growth of the population and improvements in survival rates. As a result, it is increasingly important to understand the unique medical and psychosocial needs of survivors and be aware of resources that can assist patients, caregivers, and health care providers in navigating the various phases of cancer survivorship. To highlight the challenges and opportunities to serve these survivors, the American Cancer Society and the National Cancer Institute estimated the prevalence of cancer survivors on January 1, 2012 and January 1, 2022, by cancer site. Data from Surveillance, Epidemiology, and End Results (SEER) registries were used to describe median age and stage at diagnosis and survival; data from the National Cancer Data Base and the SEER-Medicare Database were used to describe patterns of cancer treatment.

An estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012, and by January 1, 2022, that number will increase to nearly 18 million. The 3 most prevalent cancers among males are prostate (43%), colorectal (9%), and melanoma of the skin (7%), and those among females are breast (41%), uterine corpus (8%), and colorectal (8%). This article summarizes common cancer treatments, survival rates, and posttreatment concerns and introduces the new National Cancer Survivorship Resource Center, which has engaged more than 100 volunteer survivorship experts nationwide to develop tools for cancer survivors, caregivers, health care professionals, advocates, and policy makers. CA Cancer J Clin 2012. Published 2012 American Cancer Society.

Introduction

Cancer is a major public health problem in the United States and many other parts of the world. Currently, one in 3 women and one in 2 men in the United States will develop cancer in his or her lifetime. Increases in the number of individuals diagnosed with cancer each year, due in large part to aging and growth of the population, as well as improving survival rates, have led to an ever-increasing number of cancer survivors. There are several definitions of cancer survivors; here, we use the term “cancer survivor” to describe any person who has been diagnosed with cancer, from the time of diagnosis through the balance of life. There are at least 3 distinct phases associated with cancer survival, including the time from diagnosis to the end of initial treatment, the transition from treatment to extended survival, and long-term survival.

The goal of treatment is to “cure” the cancer, or prolong survival in patients with advanced disease, while preserving the highest possible quality of life in both the long and short term. Many survivors, even among those who are cancer free, must cope with the long-term effects of treatment, as well as psychological concerns such as fear of recurrence. Cancer patients and survivors also face a variety of medical and social concerns dependent on their age, comorbid conditions, socioeconomic status, and family/support network. Throughout this article, the terms “cancer patient” and “survivor” are used interchangeably. It is important to note that not all individuals with a cancer diagnosis identify with the term “cancer survivor.”

In this article, we provide statistics on cancer prevalence, common treatment modalities, and survival and review issues related to cancer treatment and survivorship.

Materials and Methods

Prevalence Estimates

Cancer prevalence was projected using the Prevalence, Incidence Approach Model method, which calculates prevalence from cancer incidence and survival and all-cause mortality. Incidence and survival were modeled by cancer type, patient sex, and age group using malignant cases diagnosed from 1975 through 2007 from the 9 oldest registries in the Surveillance, Epidemiology, and End Results (SEER) program. The most recent year of available data (2008) was excluded due to anticipated undercounts because of reporting delay. Survival was assumed to be constant from 2007 through 2022 and was estimated by fitting a parametric mixture cure survival model to the SEER data. Mortality data for 1969 through 2008 were obtained from the National Center for Health Statistics and projected mortality rates for 2009 to 2022 were obtained from the University of California at Berkeley mortality cohort life tables (available at: demog.berkeley.edu/∼bmd/). Population projections from 2008 through 2022 were obtained from the US Census Bureau.

Selected Findings

Cancer Prevalence

An estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012. This estimate does not include carcinoma in situ of any site except the urinary bladder, and does not include basal cell and squamous cell skin cancers. The 10 most common cancer sites represented among survivors are shown in Figure 1. The 3 most common cancers among male survivors are prostate (43%), colorectal (9%), and melanoma of the skin (7%). Among female survivors, the most common cancers are those of the breast (41%), uterine corpus (8%), and colorectum (8%). The majority of cancer survivors (64%) were diagnosed 5 or more years ago, and 15% were diagnosed 20 or more years ago (Table 1).

Nearly one-half (45%) of cancer survivors are aged 70 years or older, while only 5% are younger than 40 years (Table 2). As of January 1, 2022, it is estimated that the population of cancer survivors will increase to nearly 18 million (8.8 million males and 9.2 million females).

"Cancer treatment and survivorship statistics 2012" CA Cancer J Clin 2012;

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