Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys
Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care. 1. Introduction Advances in cancer detection, diagnosis, and treatment, along with the aging of the United States (US) population, have resulted in a large and growing number of cancer survivors. Recent estimates indicate that there are nearly 14 million cancer survivors in the US, more than the over 7 million cancer survivors reported in 1992 [1–3]. Although research examining sociodemographic and healthcare characteristics of nationally representative samples of cancer survivors has been conducted [4, 5], differences in these characteristics over time have rarely been examined in population-based studies. In 1992, the National Health Interview Survey (NHIS) examined characteristics of cancer survivors as part of its Cancer Control Supplement for the first time. Hewitt and colleagues published findings from the 1992 NHIS about numerous self-reported cancer survivor characteristics, including demographic information, cancer type, frequency of second opinion concerning type of cancer treatment, counseling and support group services, patient education, contact with cancer organizations, participation in clinical trials, health and life insurance coverage, and
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