Surveillance Research, American Cancer Society, Atlanta, Georgia.
Health Services Research, American Cancer Society, Atlanta, Georgia.
CA Cancer J Clin. 2022 Sep;72(5):409-436. doi: 10.3322/caac.21731. Epub 2022 Jun 23.
The number of cancer survivors continues to increase in the United States due to the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries, vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics, and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Database are presented for the most prevalent cancer types by race, and cancer-related and treatment-related side-effects are also briefly described. More than 18 million Americans (8.3 million males and 9.7 million females) with a history of cancer were alive on January 1, 2022. The 3 most prevalent cancers are prostate (3,523,230), melanoma of the skin (760,640), and colon and rectum (726,450) among males and breast (4,055,770), uterine corpus (891,560), and thyroid (823,800) among females. More than one-half (53%) of survivors were diagnosed within the past 10 years, and two-thirds (67%) were aged 65 years or older. One of the largest racial disparities in treatment is for rectal cancer, for which 41% of Black patients with stage I disease receive proctectomy or proctocolectomy compared to 66% of White patients. Surgical receipt is also substantially lower among Black patients with non-small cell lung cancer, 49% for stages I-II and 16% for stage III versus 55% and 22% for White patients, respectively. These treatment disparities are exacerbated by the fact that Black patients continue to be less likely to be diagnosed with stage I disease than White patients for most cancers, with some of the largest disparities for female breast (53% vs 68%) and endometrial (59% vs 73%). Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based strategies and equitable access to available resources are needed to mitigate disparities for communities of color and optimize care for people with a history of cancer. CA Cancer J Clin. 2022;72:409-436.
由于人口的增长和老龄化以及早期检测和治疗的进步，美国的癌症幸存者人数持续增加。为了帮助公共卫生界更好地为这些人服务，美国癌症协会和美国国家癌症研究所每三年合作一次，使用监测、流行病学和最终结果癌症登记处的发病率和生存率数据、美国疾病控制与预防中心国家卫生统计中心的生命统计数据以及美国人口普查局的人口预测数据，估计美国的癌症流行率。根据国家癌症数据库中的信息，按种族列出了最常见癌症类型的当前治疗模式，并简要描述了与癌症相关和治疗相关的副作用。截至 2022 年 1 月 1 日，有超过 1800 万美国人（男性 830 万，女性 970 万）有癌症病史。男性中最常见的三种癌症是前列腺癌（3523230 例）、皮肤黑色素瘤（760640 例）和结肠癌和直肠癌（726450 例），女性中最常见的三种癌症是乳腺癌（4055770 例）、子宫体癌（891560 例）和甲状腺癌（823800 例）。超过一半（53%）的幸存者在过去 10 年内被诊断出患有癌症，三分之二（67%）的幸存者年龄在 65 岁或以上。在治疗方面，最大的种族差异之一是直肠癌，患有 I 期疾病的黑人患者中，有 41%接受了直肠切除术或结肠直肠切除术，而白人患者中这一比例为 66%。非小细胞肺癌患者接受手术治疗的比例也明显较低，I-II 期为 49%，III 期为 16%，而白人患者分别为 55%和 22%。由于大多数癌症中，黑人患者被诊断为 I 期疾病的可能性仍然低于白人患者，这一事实使这些治疗差异更加恶化，其中一些最大的差异存在于女性乳腺癌（53%对 68%）和子宫内膜癌（59%对 73%）。尽管有越来越多的工具可以帮助患者、护理人员和临床医生在癌症生存的各个阶段进行导航，但仍需要更多基于证据的策略和公平获得现有资源，以减轻有色人种社区的差异，并优化有癌症病史的人的护理。CA 癌症杂志。2022；72:409-436.
