Cancer Cases May Double by 2050

U.S. study expects more burden with an aging population

TUESDAY, May 14, 2002 (HealthDayNews) -- As the nation grays, the number of cancer cases in this country may double by the middle of the century, with major implications for the nation's health-care system.

That's the claim of a new report that also notes an estimated 1.3 million Americans are now diagnosed with cancer each year, with much higher rates of the disease among the older age brackets.

As the population ages, and if the incidence of cancer remains unchanged, that figure could hit 2.6 million by the year 2050, the report found.

The number of cases among people aged 75 and up could triple, from 389,000 in 2000 to more than 1.1 million, the report estimates. Among even older Americans the increased caseload could be more dramatic: a fourfold jump for those 85 and over during the next four-odd decades.

"We're aging and growing faster than the [cancer] rates are going down," says lead author Brenda K. Edwards, a statistician at the National Cancer Institute. "We need to get ready for that."

The report, a sort of State of Cancer in the nation, appears in tomorrow's issue of the journal Cancer.

The number of people over 65 is expected to double by 2050, to 80 million, according to the U.S. Census Bureau.

Oncologists and other physicians are going to see a surge in older patients with cancers, Edwards says, patients who often have special needs. The elderly are much more likely than the young to have other ailments, and to be taking drugs that might interfere with cancer therapy.

The latest analysis offers the most up-to-date picture of cancer in America. While the report comes out yearly, this version is the first to be calibrated to reflect the country's current age structure, Edwards says -- a little like the way economists adjust "old" dollars for inflation to calculate their value today.

According to the analysis, cancer deaths in the United States fell by about 1 percent a year between 1993 and 1999, while the incidence of the disease leveled off. The researchers credited the drop in mortality to improved treatments and early detection of tumors, as well as declines in smoking, which contributes to a wide range of cancers.

However, cancer's burden in this country is far from equally distributed, with men, women, whites, blacks and various age groups experiencing the disease differently.

Women, for example, saw an increase in the incidence in cancer between 1987 and 1999 -- largely because of higher rates of lung and breast cancer in certain age groups -- despite the generally flat trend for the population as a whole.

Lung tumors claimed the most lives, accounting for a third of all cancer deaths. Colon and rectal cancers were the second leading killers, making up 10 percent of deaths, while breast and colon cancer combined for 14 percent of deaths.

In addition to the changing demands on doctors who treat cancer, the disease's changing demography will have a huge financial impact, experts say.

Martin Brown, an NCI researcher who studies the economic burden of cancer, has estimated that treatment of the disease and other expenses ran to nearly $157 billion in 2001.

Whether that figure will rise in step with the doubled caseload isn't clear, says Brown, who is now helping perform such an analysis.

"The good news is that there are a lot of new treatments" for cancer, he says. "The bad news is they cost money."

Cancer is on average about 50 percent more expensive to treat than other diseases, Brown says. It now consumes about 5 percent to 10 percent of the overall health-care budget. However, cancer care accounts for 20 percent of the annual budget for Medicare, the government's insurance program for the elderly.

"We suspect that it's going to become an increasing proportion" in the future, Brown says.

What To Do: To learn more about cancer, try the American Cancer Society or the National Cancer Institute.

SOURCES: Brenda K. Edwards, Ph.D., associate director, surveillance research program, National Cancer Institute, Bethesda, Md.; Martin Brown, Ph.D., researcher, National Cancer Institute, Bethesda, Md.; May 15, 2002, Cancer
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