title: Complementary and alternative medicine use among US cancer survivors.
abstract: US cancer survivors commonly use vitamins/minerals and complementary and alternative medicine (CAM). We compare use of vitamins/minerals and CAM between adult cancer survivors and cancer-free adults and estimate annual out-of-pocket expenses.
  
  
  
  Data on self-reported vitamin/mineral and CAM use in the past 12 months from the cross-sectional 2012 US National Health Interview Survey were used to estimate prevalence of use and out-of-pocket expenditures. The cohort included adults with (n = 2977) and without (n = 30,551) a self-reported cancer diagnosis.
  
  
  
  Approximately 79 % of cancer survivors and 68 % of cancer-free adults reported using ≥1 vitamins/minerals and/or CAM modality in the past year. Compared to cancer-free adults, cancer survivors were more likely to report use of vitamin/minerals (75 vs. 61 %, P < 0.001), non-vitamin/mineral natural products (24 vs. 19 %, P < 0.001), manipulative and body-based therapies (19 vs. 17 %, P = 0.03), and alternative medical systems (5 vs. 4 %, P = 0.04). Adult cancer survivors and cancer-free adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket, respectively, on vitamins/minerals and CAM. Survivors spent 60 % of the total on vitamins/minerals ($4 billion), 18 % ($1.2 billion) on non-vitamin/mineral natural products, and 7 % ($0.5 billion) on massage.
  
  
  
  Compared with cancer-free adults, a higher proportion of cancer survivors report vitamin/mineral and CAM use. Cancer survivors, who accounted for 6.9 % of the total population, accrued more than 11.4 % of the annual out-of-pocket costs on vitamins/minerals and CAM spent by US adults.
  
  
  
  Given the high use of vitamins/minerals and CAM in cancer survivors, studies are needed to analyze health outcomes and the cost/benefit ratio of such use.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA.
authors.forename: Gabriella M
authors.initials: GM
authors.lastname: John
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA.|Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Falci
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA.
authors.forename: Zaixing
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.|Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Wei-Yann
authors.initials: WY
authors.lastname: Tsai
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 733 W 168th Street, room 733, New York, NY, 10032, USA. hg2120@cumc.columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA. hg2120@cumc.columbia.edu.
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000191:economics* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cancer; Complementary medicine; Complementary therapies; Healthcare costs; Vitamins