The number of cancer survivors in the U.S. is projected to rise from 13.7 million as of January 2012 to 18 million by 2022. This 31% increase will represent a significant challenge to the healthcare system, according to a report released on Wednesday by the American Association for Cancer Research (AACR).
In its second annual report on cancer survivorship in the U.S., AACR said this growth in the survivor patient population is expected to increase the overall cost of cancer care by an estimated 27% from 2010 to 2020. The report, published online March 27 in Cancer Epidemiology, Biomarkers, and Prevention, warns that a coordinated agenda for research and healthcare practice is needed, especially for the cost and delivery of long-term follow-up care. Healthcare IT and mobile apps are expected to play a major role, according to the report.
The rise in the number of cancer survivors is attributed to the demographics of an aging population, increasing diagnoses of early-stage cancer, and more effective treatment. However, this growing population will put pressure on a healthcare system in which the demand for oncology services may outpace the supply of oncologists, according to AACR.
Older survivors add even more pressure because they are more likely to have multiple chronic diseases and not be as healthy as younger survivors. "By 2020, we expect that two-thirds of cancer survivors are going to be age 65 or older," said report co-author Julia Rowland, PhD, in a statement. Rowland is director of the Office of Cancer Survivorship at the National Cancer Institute's Division of Cancer Control and Population Sciences.
The report was based on an analysis of the Surveillance, Epidemiology, and End Results (SEER) program and population projections from the U.S. Census Bureau. In addition to estimating future survival trends, the report shows that survival is not uniform across cancer subtypes. Currently, women with breast cancer account for 22% of survivors, while men with prostate cancer make up 20%. Survivors of lung cancer, the second-most prevalent cancer diagnosed in the U.S., represent only 3%.
In 2012, 64% of the survivorship population had lived five or more years since treatment, 40% had survived 10 or more years, and 15% had survived 20 or more years. Ninety percent of breast cancer survivors are expected to live five years or longer, and men treated for early-stage prostate cancer exceed 99% five-year survival rates.
The report's authors recommend that the Institute of Medicine (IOM) or other organizations identify effective and efficient models for delivering long-term follow-up care. Formal evaluation of follow-up care models is in its infancy, and guidelines have been largely based on consensus rather than empirical data, according to the report. An efficient infrastructure to collect data needs to be established to develop these models. The data needed include tumor and treatment history, biospecimens for research, and patient-reported outcomes.
Healthcare IT systems, along with easy access to electronic medical records and data sharing among various systems, offer great potential for obtaining and managing the data, according to the report. Use of e-health and mobile health technology will also be important; however, because most survivors will continue to be older than 65, the acceptability and usability of these technologies needs to be improved for older adults.
Healthcare-related electronic technology is a rapidly evolving field, the authors noted. They called for ongoing efforts and partnerships, especially between academic researchers, IT companies, and cancer care specialists, to ensure that new devices, platforms, and applications are based on cutting-edge research.
