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Underlying mechanisms of change in cancer prevalence in older U.S. adults: contributions of incidence, survival, and ascertainment at early stages.
Abstract
<h4>Purpose</h4>To quantitatively evaluate contributions of trends in incidence, relative
survival, and stage at diagnosis to the dynamics in the prevalence of major cancers
(lung, prostate, colon, breast, urinary bladder, ovaries, stomach, pancreas, esophagus,
kidney, liver, and skin melanoma) among older U.S. adults age 65 +.<h4>Methods</h4>Trend
partitioning was applied to the Surveillance, Epidemiology, and End Results Program
data for 1973-2016.<h4>Results</h4>Growth of cancer prevalence in older adults decelerated
or even decreased over time for all studied cancers due to decreasing incidence and
improving survival for most of cancers, with a smaller contribution of the stage at
cancer diagnosis. Changes in the prevalence of cancers of the lung, colon, stomach,
and breast were predominantly due to decreasing incidence, increasing survival and
more frequent diagnoses at earlier stages. Changes in prevalence of some other cancers
demonstrated adverse trends such as decreasing survival in localized and regional
stages (urinary bladder and ovarian) and growing impact of late-stage diagnoses (esophageal
cancer).<h4>Conclusion</h4>While decelerating or decreasing prevalence of many cancers
were due to a beneficial combination of decreasing incidence and increasing survival,
there are cancers for which decelerating prevalence is due to lack of improvement
in their stage-specific survival and/or increasing frequency of diagnosis at advanced
stages. Overall, if the observed trends persist, it is likely that the burden associated
with cancer prevalence in older U.S. adults will be lower comparing to projections
based on constant increasing prevalence have previously estimated.
Type
Journal articleSubject
HumansNeoplasms
Melanoma
Esophageal Neoplasms
Skin Neoplasms
Registries
Incidence
Prevalence
Adult
Aged
Middle Aged
Male
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https://hdl.handle.net/10161/26436Published Version (Please cite this version)
10.1007/s10552-022-01595-6Publication Info
Akushevich, I; Yashkin, A; Kovtun, M; Yashin, AI; & Kravchenko, J (2022). Underlying mechanisms of change in cancer prevalence in older U.S. adults: contributions
of incidence, survival, and ascertainment at early stages. Cancer causes & control : CCC, 33(9). pp. 1161-1172. 10.1007/s10552-022-01595-6. Retrieved from https://hdl.handle.net/10161/26436.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Mikhail Kovtun
Biostatistician III
Arseniy Yashkin
Research Scientist, Senior
I am primarily a health outcomes researcher who specializes in cancers and chronic
age-related diseases, especially Alzheimer’s disease and type II diabetes mellitus. However,
I also write in epidemiology, demography, health economics and genetics. I am a specialist
in the analysis of administrative big health data. My main contributions to scholarship
can be summarized across three focus areas: health outcomes research, epidemiolog
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