Many Cancer Survivors Face Health-Related Quality
of Life Issues
First clear data on quality-of-life issues for U.S.
cancer survivors; over 30% have post-treatment physical, mental
problems; may id those at risk
Oct. 30, 2012 – Beating cancer is just the first
step. More than one third of the 12.6 million cancer survivors in the
United States have physical or mental problems that put their overall
health in jeopardy, according to researchers at Wake Forest Baptist
Their study, published in the October issue of the
journal Cancer Epidemiology, Biomarkers & Prevention, found that
25 percent of cancer survivors reported poor physical health and 10
percent reported poor mental health as compared to 10 percent and 6
percent, respectively, of adults without cancer.
The study was funded by the National Cancer
Institute (NCI), part of the National Institutes of Health (NIH) and the
Centers for Disease Control and Prevention (CDC).
"Until now, we didn't have clear data on
quality-of-life issues for the population of U.S. cancer survivors,"
said the study's lead author, Kathryn Weaver, Ph.D., assistant professor
of social sciences and health policy at Wake Forest Baptist.
"This information should help doctors and
researchers identify groups of survivors who may be at risk for
long-term problems after cancer. In addition, it can help us know if
some of the national efforts to improve life for cancer survivors are
making a difference."
The National Cancer Institute estimates that nearly 12 million
Americans with a history of cancer were alive in January 2008.
Some of these individuals were cancer free, while others still
had evidence of cancer and may have been undergoing treatment.
How Many New Cases Are Expected to Occur This Year?
About 1,638,910 new cancer cases are expected to be diagnosed in
2012. This estimate does not include carcinoma in situ
(noninvasive cancer) of any site except urinary bladder, and
does not include basal and squamous cell skin cancers, which are
not required to be reported to cancer registries.
How Many People Are Expected to Die of Cancer This Year?
In 2012, about 577,190 Americans are expected to die of cancer,
more than 1,500 people a day. Cancer is the second most common
cause of death in the US, exceeded only by heart disease,
accounting for nearly 1 of every 4 deaths.
What Percentage of People Survive Cancer?
The 5-year relative survival rate for all cancers diagnosed
between 2001 and 2007 is 67%, up from 49% in 1975-1977. The
improvement in survival reflects both progress in diagnosing
certain cancers at an earlier stage and improvements in
Survival statistics vary greatly by cancer type and stage at
diagnosis. Relative survival compares survival among cancer
patients to that of people not diagnosed with cancer who are of
the same age, race, and sex. It represents the percentage of
cancer patients who are alive after some designated time period
(usually 5 years) relative to persons without cancer.
It does not distinguish between patients who have been cured and
those who have relapsed or are still in treatment.
While 5-year relative survival is useful in monitoring progress
in the early detection and treatment of cancer, it does not
represent the proportion of people who are cured permanently,
since cancer deaths can occur beyond 5 years after diagnosis.
Although relative survival for specific cancer types provides
some indication about the average survival experience of cancer
patients in a given population, it may or may not predict
individual prognosis and should be interpreted with caution.
First, 5-year relative survival rates for the most recent time
period are based on patients who were diagnosed from 2001 to
2007 and thus, do not reflect recent advances in detection and
Second, factors that influence survival, such as treatment
protocols, other illnesses, and biological or behavioral
differences of each individual, cannot be taken into account in
the estimation of relative survival rates.
For the study, researchers analyzed data from a
2010 nationwide health survey conducted by the CDC that included data
specific to cancer survivors collected by the CDC and the NCI. The
scientists identified 1,822 cancer survivors and compared them with
24,804 adults with no history of cancer.
Breast, prostate, melanoma survivors do best
Survivors of breast cancer, prostate cancer and
melanoma fared best, with health-related quality of life levels
equivalent to or better than those of adults with no cancer history,
according to the study.
In contrast, 40 percent of survivors of cervical,
blood and colorectal cancers and survivors of cancers with a five-year
survival rate of less than 25 percent (including cancers of the liver,
lung and pancreas) were more likely to report physical problems that had
a negative impact on their quality of life. In addition, survivors in
the latter group were more likely to report mental health issues that
affected their day-to-day lives.
The researchers estimated that about 3.3 million
cancer survivors in the United States have poor physical health-related
quality of life and almost 1.4 million have poor mental health-related
quality of life.
'Due to advances in the early detection and
treatment of cancer, people are living many years after a diagnosis,"
according to the Center for Disease Control and Prevention.
"In January 2007, about 11.7 million people with a
previous diagnosis of cancer were living in the United States.
Approximately 66% of people diagnosed with cancer are expected to live
at least five years after diagnosis.
"However, disparities in health care impact
survival. Low-income men and women who have inadequate or no health
insurance coverage are more likely to be diagnosed with cancer at later
stages, when survival times are shorter.
Weaver said, "Recently, there has been a strong push for doctors
to do a better job of communicating with cancer patients about what to
expect as they finish treatment and transition to the survivor period."
"Identifying what symptoms or problems cancer
patients are facing after treatment – fatigue, pain, depression, sleep
and cognition problems – and connecting them with the right resources or
treatments is key to improving their long-term health."
Co-authors of the study are Laura P. Forsythe,
Ph.D., Catherine M. Alfano, Ph.D., and Julia H. Rowland, Ph.D., of the
National Cancer Institute; Bryce B. Reeve, Ph.D., of the University of
North Carolina at Chapel Hill; and Juan L. Rodriguez, M.P.H., Susan A.
Sabatino, M.D., and Nikki A. Hawkins, Ph.D., of the Centers for Disease
Control and Prevention.