Hewitt M, Breen N, Devesa S
Institute of Medicine, Washington, DC, USA.
J Natl Cancer Inst. 1999 Sep 1;91(17):1480-6. doi: 10.1093/jnci/91.17.1480.
BACKGROUND/METHODS: Relatively little is known about the size and makeup of the growing population of cancer survivors or about the social implications of a diagnosis of cancer. To explore these issues, we analyzed cancer survivorship information from the 1992 National Health Interview Survey (NHIS), and resulting cancer prevalence estimates were compared with those derived from cancer registry data.
According to the NHIS, there were an estimated 7.2 million adult survivors of cancer-excluding nonmelanoma skin cancer-in 1992, representing 3.9% of the U.S. adult population. Comparisons with prevalence estimates from cancer registry data suggest that cancer is underreported in the NHIS. Nearly three fifths (58.0%) of cancer survivors self-identified on the NHIS reported that their cancer was first detected when they noticed something wrong and went to a doctor. The majority (55.7%) of cancer survivors had obtained a second opinion or multiple opinions regarding their treatment. Most (58.0%) had received patient educational materials from a health care provider. However, relatively few had received counseling or participated in support groups (14.2%), contacted cancer organizations after their diagnosis (10.9%), or participated in a research study or clinical trial as part of their cancer treatment (4.7%). One ninth (10.7%) of the survivors had been denied health or life insurance coverage because of their cancer. Nearly one fifth (18.2%) of the cancer survivors who worked before or after their cancer was diagnosed experienced employment problems because of their cancer.
While cancer appears to be underreported on the 1992 NHIS, the survey provides valuable information about the medical, insurance, and employment experience of cancer survivors selected from a nationally representative sample of U.S. households.
背景/方法：对于不断增长的癌症幸存者群体的规模和构成，以及癌症诊断的社会影响，我们了解得相对较少。为了探究这些问题，我们分析了1992年全国健康访谈调查（NHIS）中的癌症幸存者信息，并将由此得出的癌症患病率估计值与癌症登记数据得出的估计值进行了比较。
根据NHIS的数据，1992年估计有720万成年癌症幸存者（不包括非黑色素瘤皮肤癌），占美国成年人口的3.9%。与癌症登记数据得出的患病率估计值相比，表明NHIS中癌症报告不足。在NHIS中自我认定的癌症幸存者中，近五分之三（58.0%）报告称，他们的癌症是在注意到身体不适并就医时首次被发现的。大多数（55.7%）癌症幸存者就其治疗方案征求了第二种意见或多种意见。大多数（58.0%）从医疗保健提供者那里获得了患者教育资料。然而，相对较少的人接受过咨询或参加过支持小组（14.2%），在诊断后联系过癌症组织（10.9%），或作为癌症治疗的一部分参加过研究或临床试验（4.7%）。九分之一（10.7%）的幸存者因患癌症而被拒绝提供健康或人寿保险。在癌症诊断之前或之后工作的癌症幸存者中，近五分之一（18.2%）因患癌症而遇到就业问题。
虽然1992年NHIS中癌症报告似乎不足，但该调查提供了有关从美国家庭具有全国代表性样本中选取的癌症幸存者的医疗、保险和就业经历的宝贵信息。
