Multiple cancer prevalence: a growing challenge in long-term survivorship.
OBJECTIVE
The present study was designed to estimate the number of and describe the pattern of disease among cancer survivors living with a history of multiple malignant tumors in the United States.


METHODS
Incidence and follow-up data from the Surveillance, Epidemiology, and End Results program (1975-2001) were used to calculate the number of survivors with more than one malignant primary at January 1, 2002. U.S. prevalence counts were calculated by multiplying the age, sex, and race-specific prevalence proportions from the Surveillance, Epidemiology, and End Results program by the corresponding U.S. populations.


RESULTS
We estimate that 756,467 people in the United States have been affected by cancer more than once between 1975 and 2001, representing almost 8% of the current cancer survivor population. Women whose first primary in that period was breast cancer represent 25% of survivors with multiple cancers, followed by men and women (15%) whose first primary was colorectal cancer and men (13%) whose first primary was prostate cancer.


CONCLUSIONS
The findings in this report have important implications for public health practice. With individuals diagnosed with cancer living longer and the aging of the U.S. population, the number who will develop multiple malignancies is expected to increase. As a consequence, there is a growing need to promote effective cancer screening along with healthy life-styles among these at-risk populations if we are to ensure optimal physical and psychosocial well-being of these long-term cancer survivors and their families. Efforts to design and evaluate effective, efficient, and equitable approaches to surveillance for second malignancies will be critical in reducing the national burden of cancer.
Mariotto
Angela B
AB
Division of Cancer Control and Population Sciences, National Cancer Institute, 6116 Executive Boulevard, Suite 540, MSC 8317, Bethesda, MD 20892, USA. mariotta@mail.nih.gov
Rowland
Julia H
JH
Ries
Lynn A G
LA
Scoppa
Steve
S
Feuer
Eric J
EJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000401:mortality; D016012:Poisson Distribution; D015995:Prevalence; D018426:SEER Program; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology