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America’s Cancer Survivor Dilemma

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Dramatic improvements in cancer detection, treatment and technology over the last 40 years means more Americans than ever before are living with, and beyond, their cancer diagnosis.

In 1971, the year the National Cancer Act was signed into law, there were about 3 million survivors. America’s commitment to increase its cancer survivor population through the expansion of research, training programs and public education have been, by all accounts, a success.

By 2008, the number of survivors had grown to nearly 12 million. At the current pace, the number of survivors is expected to reach more that 18 million by 2020.

Remarkable gains have been realized in breast cancer in women, prostate cancer, and colorectal cancer. Researchers attribute this high survival to improved detection and screening.

In part, the increase in future cancer survivorship will be credited to new therapies and less invasive procedures, but that doesn’t tell the whole story.

As America’s Baby boomers move into retirement age over the next decade, the population of cancer survivors, age 65 or older, is expected to increase by approximately 42 percent. These numbers could strain an already burdened medical system.

“We can expect a dramatic increase in the number of older adults who are diagnosed with or carry a history of cancer,” Julia Rowland, Ph.D., director of the Office of Cancer Survivorship in the Division of Cancer Control and Population Sciences at the National Cancer Institute (NCI) said in a written statement.

There are about 76 million boomers, the generation of people born after World War II in the U.S. between 1946 and 1964. Boomers comprise 29 percent of the total U.S. population and the first turn age 65 this year.

As the population ages, the absolute number of people treated for cancer will increase faster than the overall population, and cancer prevalence will increase relative to other disease categories — even if cancer incidence rates remain constant or decrease somewhat, according to NCI.

“Cancer is largely a disease of aging, so we’re seeing yet another effect of the baby boom generation and we need to prepare for this increase,” said Rowland, who notes, the coming wave will present some unique challenges. “As a population, the number of oncologists and geriatric specialists is decreasing just as the need for these specialists is increasing.”

Medical technology may be getting better, but paying for cancer treatment in the future could be more difficult for a bigger segment of the population struggling to make ends meet. Findings from the 2010 census found more than 50 million people were uninsured last year, almost one in six U.S. residents, the Census Bureau reported. The percentage with private insurance was the lowest since the government began keeping data in 1987.

Dr. Gary Lyman, MD, MPH, a senior fellow at Duke University’s Center for Clinical Health Policy Research told Medscape Medical News earlier this year, that as survival rates have increased, so have the cost of cancer services, such as drugs, hospitalizations and home care. “The true increase in the cost of cancer to patients, families, and society is likely to be considerably greater [from now to 2020].”

Rowland’s annual report, published in October issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research agrees, “this demographic shift has important implications for future health care needs and costs of the U.S. population.”

According to a study published online January 12, 2011 in the Journal of the National Cancer Institute, the associated costs of cancer care will be $157.77 billion — $33.20 billion more than in 2010, assuming incidence, survival and annual cost remain the same.

However, the study’s authors, led by NCI’s Angela Mariotto, PhD, estimate the cost of care is more likely to increase annually by 2 percnet in the initial and last-year-of-life phases of care. Given the likely increases, the total national cost of cancer in 2020 is projected to be $173 billion, a 39% increase from 2010.

There is a bright side to the story. Beside the fact that more people are winning their cancer battles, Rowland says the U.S. may be fortunate in other ways: Baby boomers are healthier than previous generations and new technologies including electronic health records and technology-based post-treatment plans may allow for better communication and follow-up across the full spectrum of health care support services.

Online Resources: Survivorship: Living with and beyond Cancer. NCI Office of Cancer Survivorship. http://www.cancer.gov/cancertopics/coping/survivorship

Lynette Summerill, an award-winning writer and scuba enthusiast lives in San Diego, CA with her husband and two canine kids. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in newspapers and magazines around the world.


NCI Cancer Bulletin. A Conversation with Dr. Angela Mariotto and Dr. Martin Brown on the Rising Costs of Cancer Care. Vol.8, No.2, 25 Jan. 2011 accessed online 5 Oct. 2011 at http://www.cancer.gov/ncicancerbulletin/012511/page4

Older Cancer Population to Increase Substantially. American Association for Cancer Research Media Release. Jeremy Moore.
Cancer Epidemiology, Biomarkers & Prevention. Cancer Survivors: A Booming Population. Draft copy. J.H. Rowland et al.
To be published October 2011.

NCI. Cancer Trends Progress Report 2009-2010. Accessed 5 October 2011 at:

Medscape Medical News. Cost of Cancer in the United States to Go Up, Up, Up:Targeted therapies could cause further increases. Nick Mulcahy. Accessed online 5 Oct. 2011 at

Reviewed October 6, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.