An assessment of progress in cancer control

Siegel, Rebecca L.; Jemal, Ahmedin; Wender, Richard C.; Gansler, Ted; Ma, Jiemin; Brawley, Otis W.

doi:10.3322/caac.21460

Cited by 162 publications

(119 citation statements)

References 63 publications

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Section: Selected Findingsmentioning

confidence: 99%

“…Lower socioeconomic status (SES), whether measured at the individual or area level, is associated with numerous health disadvantages and higher mortality across race and ethnicity . A recent study estimated that approximately one‐third (34%) of cancer deaths in Americans aged 25 to 74 years could be averted with the elimination of socioeconomic disparities . Notably, socioeconomic deprivation was associated with lower cancer mortality prior to the mid‐1980s because of the later development of effective treatment and the historically elevated risk of lung and colorectal cancers among individuals with high SES …”

Section: Selected Findingsmentioning

confidence: 99%

“…[70][71][72] A recent study estimated that approximately one-third (34%) of cancer deaths in Americans aged 25 to 74 years could be averted with the elimination of socioeconomic disparities. 72 Notably, socioeconomic deprivation was associated with lower cancer mortality prior to the mid-1980s because of the later development of effective treatment and the historically elevated risk of lung and colorectal cancers among individuals with high SES. 73,74 County-level SES indicators only indirectly reflect individual SES, but are valuable because the county is the smallest geographic unit for which policy is legislated.…”

Section: Cancer Disparities By Socioeconomic Statusmentioning

confidence: 99%

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Cancer statistics, 2019

Siegel

Miller

Jemal

2019

CA A Cancer J Clinicians

Self Cite

18,969

14,083

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Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2015, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2016, were collected by the National Center for Health Statistics. In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2006‐2015) was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate (2007‐2016) declined annually by 1.4% and 1.8%, respectively. The overall cancer death rate dropped continuously from 1991 to 2016 by a total of 27%, translating into approximately 2,629,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the racial gap in cancer mortality is slowly narrowing, socioeconomic inequalities are widening, with the most notable gaps for the most preventable cancers. For example, compared with the most affluent counties, mortality rates in the poorest counties were 2‐fold higher for cervical cancer and 40% higher for male lung and liver cancers during 2012‐2016. Some states are home to both the wealthiest and the poorest counties, suggesting the opportunity for more equitable dissemination of effective cancer prevention, early detection, and treatment strategies. A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.

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Section: Selected Findingsmentioning

confidence: 99%

Section: Selected Findingsmentioning

confidence: 99%

Section: Cancer Disparities By Socioeconomic Statusmentioning

confidence: 99%

See 1 more Smart Citation

Cancer statistics, 2019

Siegel

Miller

Jemal

2019

CA A Cancer J Clinicians

Self Cite

18,969

14,083

View full text Add to dashboard Cite

show abstract

“…For example, 5‐year relative survival rates for patients aged 85 years and older with either local‐stage or regional‐stage lung cancer are about 3 times higher in whites compared with blacks . This disparity may reflect inequalities in access to and receipt of quality medical care and differences in the burden of comorbidities and other age‐associated conditions . Despite relatively universal access to basic health insurance through Medicare, some costs of cancer care are not fully covered by Medicare and can be burdensome for older patients with limited, fixed incomes .…”

Section: Selected Findingsmentioning

confidence: 99%

“…39 This disparity may reflect inequalities in access to and receipt of quality medical care and differences in the burden of comorbidities and other age-associated conditions. [40][41][42] Despite relatively universal access to basic health insurance through Medicare, some costs of cancer care are not fully covered by Medicare and can be burdensome for older patients with limited, fixed incomes. 43 Importantly, growth of the racial/ ethnic minority population at highest mortality risk will lead to increasing diversity over the next several decades in the oldest old age group.…”

Section: Racial/ethnic Variation In Ratesmentioning

confidence: 99%

Cancer statistics for adults aged 85 years and older, 2019

DeSantis

Miller

Dale

et al. 2019

CA A Cancer J Clinicians

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279

199

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Adults aged 85 years and older, the “oldest old,” are the fastest‐growing age group in the United States, yet relatively little is known about their cancer burden. Combining data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the National Center for Health Statistics, the authors provide comprehensive information on cancer occurrence in adults aged 85 years and older. In 2019, there will be approximately 140,690 cancer cases diagnosed and 103,250 cancer deaths among the oldest old in the United States. The most common cancers in these individuals (lung, breast, prostate, and colorectum) are the same as those in the general population. Overall cancer incidence rates peaked in the oldest men and women around 1990 and have subsequently declined, with the pace accelerating during the past decade. These trends largely reflect declines in cancers of the prostate and colorectum and, more recently, cancers of the lung among men and the breast among women. We note differences in trends for some cancers in the oldest age group (eg, lung cancer and melanoma) compared with adults aged 65 to 84 years, which reflect elevated risks in the oldest generations. In addition, cancers in the oldest old are often more advanced at diagnosis. For example, breast and colorectal cancers diagnosed in patients aged 85 years and older are about 10% less likely to be diagnosed at a local stage compared with those diagnosed in patients aged 65 to 84 years. Patients with cancer who are aged 85 years and older have the lowest relative survival of any age group, with the largest disparities noted when cancer is diagnosed at advanced stages. They are also less likely to receive surgical treatment for their cancers; only 65% of breast cancer patients aged 85 years and older received surgery compared with 89% of those aged 65 to 84 years. This difference may reflect the complexities of treating older patients, including the presence of multiple comorbidities, functional declines, and cognitive impairment, as well as competing mortality risks and undertreatment. More research on cancer in the oldest Americans is needed to improve outcomes and anticipate the complex health care needs of this rapidly growing population.

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Ensuring Equity and Justice in the Care and Outcomes of Patients With Cancer

Polite

Gluck

Brawley

2019

JAMA

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In 1966, Rev Martin Luther King Jr told the Medical Committee for Human Rights, "Of all the forms of inequality, injustice in health is the most shocking and the most inhuman…." The problem of health inequity rings especially true for cancer. In 1980, all women in Chicago had the same cancer mortality rate: there was no disparity. By 2007, black women were substantially more likely than white women to die from breast cancer and metastatic colon cancer, even as, or perhaps because, therapies improved. Historical shifts have produced the wide racial gaps in survival seen today for many cancers, and this injustice has been exacerbated by government inaction.While exact data on unnecessary deaths from cancer care disparities are not precisely documented, an estimated 134 000, or 22% of the 610 000 individuals in the United States who died of cancer in 2018, could have lived if they had the health care access, quality, treatment, and outcomes of college-educated individuals. 1 For all this profound inequity, addressing cancer injustice does not require a technological solution. This is known because some communities have reduced racial disparities, whereas others have eliminated them altogether. The biological, psychosocial, and socioeconomic complexity

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An assessment of progress in cancer control

Cited by 162 publications

References 63 publications

Cancer statistics, 2019

Cancer statistics, 2019

Cancer statistics for adults aged 85 years and older, 2019

Ensuring Equity and Justice in the Care and Outcomes of Patients With Cancer

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