18 Million Cancer Survivors Expected by 2022

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An aging population coupled with improved treatment methods mean more people will survive cancer. But at what cost?

The American Association for Cancer Research (AACR) released its second Annual Report on Cancer Survivorship, which shows that the current 13.7 million cancer survivors in the U.S. will likely swell by 31% to 18 million by the year 2022.

Some of the rise is due to the aging population; the risk of the most common cancers, including breast, prostate and lung, increases with age, and the researchers estimate that two-thirds of cancer survivors will be over the age of 65 in 2020. But advances in early detection and treatment are also contributing to helping people are live longer after diagnosis.

(MORE: Cancer Dream Teams: Road to a Cure?)

Using two government-funded databases, the Surveillance, Epidemiology and End Results Program and the U.S. Census Bureau’s population projections, the scientists estimate that women with breast cancer will make up 22% of cancer survivors in coming decades, while men with prostate cancer will make-up another 20%. Patients with lung cancer, however, may account for only 3% of survivors, reflecting still-nascent efforts to successfully treat the disease.

While the survival trend is encouraging, it may come at a price. Cancer survivors generally have twice the annual medical costs that patients without cancer do, because of they need routine monitoring for recurring tumors, as well as for side effects from their treatment or long term effects of their disease. Cancer drug shortages are also becoming more common, and the high demand for cancer-related care could overwhelm the current supply of oncologists. “The growing number of older survivors also presents a unique challenge to the healthcare system because older cancer survivors are more likely to have multiple chronic diseases and tend to experience poorer physical functioning than younger survivors,” the authors write.

(MORE: A Shot at Cancer)

The cost of cancer care will also continue to rise in tandem with the number of survivors. According to the report, it is estimated that population growth will increase the cost of cancer care by 27% by 2020. The authors write:

Health care costs in the first year after a cancer diagnosis tend to be higher than annual costs thereafter for survivors who are not in their last year of life. Nevertheless, among survivors who are more than 1-year post-diagnosis, annual healthcare expenditures are double that of the general population, suggesting that the economic burden of cancer in terms of medical expenditures is both considerable and persistent.

To address some of the issues the growing population presents, the researchers proposed the following recommendations:

  • Improve methods for delivering long-term follow up care: Few studies adequately analzye the best ways to evaluate and monitor side effects and long term effects of cancer treatments, and the researchers say more data is needed to evaulate the most cost effective strategy for keeping cancer survivors healthy.
  • Collect long-term clinical, psychosocial, and behavioral data from adult cancer survivors: In order to find the most effective ways to care for patients, more data is needed to identify best practices.
  • Exploit electronic health care records and other technologies to coordinate and improve survivors’ care: With the growth in electronic medical records (EMR) and personal health records, researchers can begin to capture important biological and self-reported data in real-time, and determine if acting on patterns and trends in these records can improve care.
  • Improve palliative care:  Research has shown that addressing pain, discomfort and other cancer-related symptoms with interventions such as massage, group therapy sessions and meditation, can improve quality of life and lower health care costs of cancer patients.

(MORE: On the Horizon at Last, Cancer Drugs that Harness the Body’s Own Immune System)

“How to ensure that these patients lead not only long lives, but healthy and productive lives, will be a vital challenge to all of us,” said Julia Rowland, the director of the Office of Cancer Survivorship at the National Cancer Institute in a statement.

The report is published in the AACR’s journal Cancer Epidemiology, Biomarkers & Prevention.


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"Survivors." Do all the people treated for "Stage 0" and "pre-cancer" abnormalities count in those numbers?

And how many of them are "chronic" patients who are neither cured nor in remission, just "managing" cancers that aren't killing them but won't go away?

How many are living decently with manageable pain and disabilities vs. poorly after debilitated and bankrupt by treatment?

And, lastly, how many "survivors," especially of childhood cancer, end up dying fairly horrible deaths later in life from cancers caused by "successful" treatments.

Next to the money, answers to the above questions are the real story behind those numbers. All that money, though. The doctors and medical companies always get paid by someone, so nobody is in a rush to actually figure out and effectively treat cancer.


Early detection of cancer boosts the five-year survival rate (FSR), but FSR is a flawed and misleading statistic. Imagine a group of 100 women who are diagnosed with cancer because they feel a breast lump at age 60. With treatment, all of them live until 64. The five-year survival rate (FSR) for this unscreened group is 0%. Now imagine that these women are screened and diagnosed with breast cancer at age 55. With early treatment, they live nine more years. The FSR for this group is 100% even though the women don't live any longer. Moreover, the screened women end up spending five extra years suffering from the side effects of chemotherapy, radiation and surgery. And, of course, they also boost the health care spending by millions of dollars.

No controlled study has shown that mammography screening increases the life expectancy of women significantly. A meta-analysis by the Cochrane group has estimated that such screening extends their life expectancy by about one day. However, the screening process itself takes longer than one day. Screening also leads to a 30% overdiagnosis because of false positive results. Such overdiagnosis also inflates the overall survival statistics.