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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.

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Date
2022-09
Authors
Akushevich, I
Yashkin, A
Kovtun, M
Yashin, AI
Kravchenko, J
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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 article
Subject
Humans
Neoplasms
Melanoma
Esophageal Neoplasms
Skin Neoplasms
Registries
Incidence
Prevalence
Adult
Aged
Middle Aged
Male
Permalink
https://hdl.handle.net/10161/26436
Published Version (Please cite this version)
10.1007/s10552-022-01595-6
Publication 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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Scholars@Duke

Kovtun

Mikhail Kovtun

Biostatistician III
Yashkin

Arseniy Yashkin

Research Scientist, Senior
Alphabetical list of authors with Scholars@Duke profiles.
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