The Burden of Selected Cancers in The United States: Health Behaviors and Healthcare Utilization of Survivors

To examine the prevalence, functional limitations and healthcare utilization of survivors of the highest incidence cancers in the United States (US). We included adults aged 18 years or older from Surveillance Epidemiology and End Results (SEER) 9 1973-2012, National Health Interview Survey (NHIS) 2013, and Medical Expenditure Panel Survey (MEPs) 2011. Based on SEER incidence, we examined survivors of the eleven most frequently diagnosed cancers within the United States. Chi-square tests and one-way analyses of variance were utilized to assess whether cancer survivors differed from non-cancer controls on behavioral characteristics, prevention, and cost of care. Breast, prostate, lung, hematologic malignancies, melanoma, colon/rectal, bladder, kidney/renal, uterine, thyroid and pancreatic cancers were included as the 11 cancers with highest incidence. Breast cancer was the highest incident cancer with a rate of 156.4 per 100,000 adult women. The second incident cancer was prostate cancer with a rate of 167.2 per 100,000 adult men. Fifty-eight percent of 40-64 year old adults diagnosed with cancer in the past year have pain versus 31.3% of adults without a cancer history (p=0.0002). Cancer survivors 65 years of age and older were found to have higher rates of any functional limitation than cancer-free adults (p=0.0016). An estimated 13.5 million adults with a history of cancer spend $169.4 billion (B) a year on cancer treatment. Cancers with the highest direct expenditures are breast ($39B), prostate ($37B), and hematologic malignancies ($25B). Office-based visits account for the majority of direct medical spending associated with breast (29.9%), prostate (21.9%), and lung (28.5%) cancers. Among persons with a history of cancer the prevalence of obesity is the same in men and women 67%. Understanding the utilization use, health and wellbeing of cancer survivors can inform how to approach future interventions to improve long term care.