John Gabriella M, Hershman Dawn L, Falci Laura, Shi Zaixing, Tsai Wei-Yann, Greenlee Heather
Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA.
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
J Cancer Surviv. 2016 Oct;10(5):850-64. doi: 10.1007/s11764-016-0530-y. Epub 2016 Feb 26.
US cancer survivors commonly use vitamins/minerals and complementary and alternative medicine (CAM). We compare use of vitamins/minerals and CAM between adult cancer survivors and cancer-free adults and estimate annual out-of-pocket expenses.
Data on self-reported vitamin/mineral and CAM use in the past 12 months from the cross-sectional 2012 US National Health Interview Survey were used to estimate prevalence of use and out-of-pocket expenditures. The cohort included adults with (n = 2977) and without (n = 30,551) a self-reported cancer diagnosis.
Approximately 79 % of cancer survivors and 68 % of cancer-free adults reported using ≥1 vitamins/minerals and/or CAM modality in the past year. Compared to cancer-free adults, cancer survivors were more likely to report use of vitamin/minerals (75 vs. 61 %, P < 0.001), non-vitamin/mineral natural products (24 vs. 19 %, P < 0.001), manipulative and body-based therapies (19 vs. 17 %, P = 0.03), and alternative medical systems (5 vs. 4 %, P = 0.04). Adult cancer survivors and cancer-free adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket, respectively, on vitamins/minerals and CAM. Survivors spent 60 % of the total on vitamins/minerals ($4 billion), 18 % ($1.2 billion) on non-vitamin/mineral natural products, and 7 % ($0.5 billion) on massage.
Compared with cancer-free adults, a higher proportion of cancer survivors report vitamin/mineral and CAM use. Cancer survivors, who accounted for 6.9 % of the total population, accrued more than 11.4 % of the annual out-of-pocket costs on vitamins/minerals and CAM spent by US adults.
Given the high use of vitamins/minerals and CAM in cancer survivors, studies are needed to analyze health outcomes and the cost/benefit ratio of such use.
美国癌症幸存者普遍使用维生素/矿物质以及补充和替代医学（CAM）。我们比较成年癌症幸存者与未患癌症的成年人在维生素/矿物质和CAM使用方面的情况，并估算年度自付费用。
利用2012年美国国民健康访谈调查的横断面数据中关于过去12个月自我报告的维生素/矿物质和CAM使用情况，来估算使用 prevalence 和自付支出。该队列包括自我报告有癌症诊断的成年人（n = 2977）和无癌症诊断的成年人（n = 30551）。
在过去一年中，约79%的癌症幸存者和68%未患癌症的成年人报告使用了≥1种维生素/矿物质和/或CAM方式。与未患癌症的成年人相比，癌症幸存者更有可能报告使用维生素/矿物质（75%对61%，P < 0.001）、非维生素/矿物质天然产品（24%对19%，P < 0.001）、手法和基于身体的疗法（19%对17%，P = 0.03）以及替代医学系统（5%对4%，P = 0.04）。成年癌症幸存者和未患癌症的成年人在维生素/矿物质和CAM方面的年度自付费用分别估计为67亿美元和520亿美元。幸存者将总支出的60%用于维生素/矿物质（40亿美元），18%（12亿美元）用于非维生素/矿物质天然产品，7%（5亿美元）用于按摩。
与未患癌症的成年人相比，更高比例的癌症幸存者报告使用维生素/矿物质和CAM。占总人口6.9%的癌症幸存者，占美国成年人在维生素/矿物质和CAM方面年度自付费用的11.4%以上。
鉴于癌症幸存者对维生素/矿物质和CAM的高使用率，需要开展研究来分析此类使用的健康结果和成本效益比。
