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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2022-09
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Abstract
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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 +.Methods
Trend partitioning was applied to the Surveillance, Epidemiology, and End Results Program data for 1973-2016.Results
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).Conclusion
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
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Akushevich, I, A Yashkin, M Kovtun, AI Yashin and J Kravchenko (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.
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Scholars@Duke
Arseniy Yashkin
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, epidemiology and methodology, and health economics. Some of my most important findings are described below.
Mikhail Kovtun
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