There is growing optimism in the field of oncology today with improvements in prevention, early detection, and treatment of many forms of cancer. Furthermore, cancer statistics for 2003 show a continued decline in the death rate from all cancers combined and from each of the four major cancer sites.
While this is truly encouraging, it also means that the burden of cancer in the US population will increase simply by having more individuals living with cancer. Moreover, there are trends in the population that will compound this problem—the population is aging and diversifying.
Cancer occurs predominantly in older persons. The number of people living with cancer is expected to double from 1.3 to 2.6 million between the years 2000 to 2050. The absolute number of cancers occurring in persons aged 65 years and older is also expected to double. Concurrently, the aging of the population is occurring across all race and ethnic groups.
Cancer is especially challenging in the elderly for a number of reasons. Individuals with cancer often have other chronic illnesses, which make diagnosis, treatment, and coping more difficult. Caregivers may also be frail. This situation exacerbates the demand for supportive and general medical services. As care is delivered more and more in outpatient settings, the need for transportation, home care, prescription coverage, and education is accentuated. Thus, the overall need for supportive services for people with cancer is emerging as a major issue for the health care system.
As the US population is aging, it is also diversifying. By the year 2050, according to US Census Bureau estimates, Hispanics will account for almost 25 percent of the population, and Blacks, Asian Americans, and Native Americans will combine to total another 25 percent of the population. These groups, on the whole, tend to experience differences in incidence, prevalence, and mortality from cancer, especially when compared with that of Whites. These differences are poorly understood, and currently, these groups are underrepresented in clinical trials.
These populations also have more socioeconomic needs. Access to care is more complicated. Language and cultural barriers exist. These trends in demographics will also place increased demands on the health care system.
The American Cancer Society has identified targeted goals to be achieved by 2015. In addition to decreasing the overall incidence of cancer by 25 percent and decreasing the overall mortality rate by 50 percent, our goal is to measurably improve the quality of life of all cancer survivors. Survivors encompass anyone living with cancer from the time of diagnosis to the end of life. Indeed, the mission statement of the American Cancer Society includes our “dedication … to diminishing suffering from cancer.” The American Cancer Society recognizes that these are challenging goals, and that collaboration with all sectors is necessary to achieve them.
The achievement of decreasing mortality from cancer one step at a time, as the 2003 statistics indicate, means that there will also be an increase in the number of persons living with cancer. This raises significant issues for each individual and for his or her loved ones. It also means a significant burden of cancer is emerging in the population that we all will bear. This challenge will only be compounded over time by the aging and diversifying of the population. Clearly, we must develop the medical care system to be able to provide quality care so that all individuals will have the best quality to their lives while living with cancer.