美国2019年癌症治疗与生存统计报告（英文）-2019.6-23页_1mb

Cancer Treatment and Survivorship Statistics, 2019 Summary

Core Content

This document provides an overview of cancer prevalence, treatment patterns, and health effects among cancer survivors in the United States as of January 1, 2019, and projections for 2030. It highlights the growing number of cancer survivors due to population aging, increased incidence, and improved survival rates from advances in early detection and treatment. The report is a collaboration between the American Cancer Society and the National Cancer Institute.

Main Points

Cancer Prevalence

• Total Survivors (2019): Over 16.9 million Americans with a history of cancer were alive on January 1, 2019.
• Projected Survivors (2030): This number is expected to rise to over 22.1 million by January 1, 2030.
• Most Common Cancers (2019):
  • Males: Prostate (3,650,030), Colon and Rectum (776,120), Melanoma (684,470)
  • Females: Breast (3,861,520), Uterine Corpus (807,860), Colon and Rectum (768,650)
• Age Distribution:
  • 64% of survivors are aged 65 years or older.
  • Prostate cancer survivors are predominantly aged 65 and older (82%), while melanoma survivors are more evenly distributed.
• Years Since Diagnosis:
  • Over 56% were diagnosed within the past 10 years.
  • 18% were diagnosed 20 or more years ago.

Treatment Patterns

• Breast Cancer:
  • Early-stage (I or II) breast cancer treatment: 49% BCS with adjuvant radiation, 34% mastectomy.
  • Stage III disease: 68% mastectomy, often with adjuvant chemotherapy.
  • Stage IV disease: 56% receive radiation and/or chemotherapy alone, 25% receive no treatment.
  • Hormonal therapy is used in 81% of hormone receptor-positive tumors, slightly lower in metastatic cases (71%).
• Colon and Rectum Cancer:
  • 84% of stage I and II patients undergo colectomy without chemotherapy.
  • Two-thirds of stage III patients receive adjuvant chemotherapy.
• Other Cancers:
  • Treatment modalities include surgery, radiation therapy, and systemic treatments such as chemotherapy, targeted therapy, and immunotherapy.
  • Some cancers, like non-Hodgkin lymphoma and testicular cancer, have limited data due to small case numbers.

Health Effects

• Short-term and Long-term Effects:
  • Lymphedema: 19.9% of women undergoing axillary lymph node dissection, 5.6% with sentinel lymph node biopsy.
  • Persistent pain: Approximately one-third of women develop it after surgery or radiation.
  • Premature menopause and impaired fertility: Often associated with chemotherapy.
  • Neuropathy: Common with taxane-based chemotherapy.
  • Cardiomyopathy and congestive heart failure: Risks associated with anthracyclines and HER2-targeted drugs.
  • Osteoporosis: Linked to aromatase inhibitors and tamoxifen.
  • Cognitive impairments and chronic fatigue: Reported in breast cancer survivors.

Key Information

• Data Sources:
  • Incidence and survival data from SEER registries.
  • Vital statistics from the CDC's National Center for Health Statistics.
  • Population projections from the US Census Bureau.
  • Treatment data from the National Cancer Data Base (NCDB).
• Methodology:
  • Prevalence is estimated using the Prevalence Incidence Approach Model.
  • Incidence and mortality projections are based on 5-year average rates from 2011–2015.
  • Survival rates are calculated using relative survival, adjusting for normal life expectancy.
• Disparities:
  • Black women have lower survival rates at all stages compared to white women.
  • Insurance status and socioeconomic factors contribute to these disparities.
  • Higher incidence of triple-negative breast cancer among black women is a contributing factor.

Conclusion

The increasing number of cancer survivors underscores the need for improved follow-up care and tailored resources to address the unique medical and psychosocial needs of this population. While treatment patterns and survival rates have improved, disparities in care and outcomes persist, particularly among racial and socioeconomic groups. Continued research and development of evidence-based survivorship resources are essential to optimize long-term health outcomes.