During the next 20 years, the number of new cancer cases diagnosed annually in the United States will increase by 45 percent, from 1.6 million in 2010 to 2.3 million in 2030, with a dramatic spike in incidence predicted in the elderly and minority populations, according to research from The University of Texas M. D. Anderson Cancer Center.
The study, published online in Journal of Clinical Oncology on April 29, is the first to determine such specific long-term cancer incidence projections.
"In 2030, 70 percent of all cancers will be diagnosed in the elderly and 28 percent in minorities, and the number of older adults diagnosed with cancer will be the same as the total number of Americans diagnosed with cancer in 2010," said Ben Smith, M.D., adjunct assistant professor in Anderson's Department of Radiation Oncology and the study's senior author.
Also alarming is that a number of the types of cancers that are expected to increase, such as liver, stomach and pancreas, which still have tremendously high mortality rates, Smith said.
To conduct their research, Smith and his team accessed the United States Census Bureau statistics, updated in 2008 to project population growth through 2050, and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) registry, the premier population-based cancer registry representing 26 percent of the country's population.
The researchers found that from 2010 to 2030, the population is expected to grow by 19 percent (from 305 to 365 million). The total number of cancer cases will increase by 45 percent (from 1.6 to 2.3 million), with a 67 percent increase in cancer incidence in older Americans, compared to an 11 percent increase in those under the age of 65.
With respect to race, a 100 percent increase in cancer is expected for minorities. For white Americans, a 31 percent increase is projected. The rates of cancer in blacks, American Indian-Alaska Native, multi-racial, Asian-Pacific Islanders and Hispanics will increase by 64 percent, 76 percent, 101 percent, 132 percent and 142 percent, respectively.
Regarding disease-specific findings, Smith and his team found that the leading cancer sites are expected to remain constant: breast, prostate, colon and lung. However, cancer sites with the greatest increase in incidence expected are: stomach (67 percent); liver (59 percent); myeloma (57 percent); pancreas (55 percent); and bladder (54 percent).
Given these statistics, the role of screening and prevention strategies becomes all the more vital and should be strongly encouraged, said Smith. In the study, Smith and his team say that vaccinations for hepatitis B and HPV; the chemoprevention agents tamoxifen and raloxifene; interventions for tobacco and alcohol; and removal of pre-malignant lesions, such as colon polyps, are critical to maintaining health.
These findings also highlight two issues that must be addressed simultaneously: clinical trial participation and the increasing cost of cancer care, Smith said. Historically, both older adults and minorities have been under-represented in such studies, and, therefore, are vulnerable to sub-optimal cancer treatment. Meanwhile, the cost of cancer care is growing at a rate that's not sustainable, Smith said.
"The fact that these two groups have been under-represented in clinical research participation, yet their incidence of cancer is growing so rapidly, reflects the need for therapeutic trials to be more inclusive and address issues that are particularly relevant to both populations. In addition, as we design clinical trials, we need to seek not only the treatment that will prolong survival, but prolong survival at a reasonable cost to patients. These are two issues that oncologists need to be much more concerned about and attuned to," Smith concluded.
Source: The University of Texas M. D. Anderson Cancer Center.