The percentage of survivors of cancer reporting functional limitations in the United States has more than doubled over the past 20 years, according to a new study in the journal JAMA Oncology. The work, published May 11, was a collaborative effort from investigators at the Johns Hopkins Kimmel Cancer Center, the Dell Medical School in Austin, Texas, and the University of Minnesota’s Masonic Cancer Center in Minneapolis.
In a study of 51,258 survivors weighted to represent a larger population of approximately 178.8 million people, 3.6 million survivors reported a functional limitation in 1999. That number increased to 8.2 million in 2018 — a 2.25-fold increase. The adjusted prevalence of functional limitation was highest among survivors of pancreatic (80.3%) and lung (76.5%) cancers and lowest for survivors of melanoma (62.2%), breast (61.8%) and prostate (59.5%) cancers.
The investigators reviewed 20 years of records from the National Health Interview Survey, an annual study from the Centers for Disease Control and Prevention that asks patients across the United States about their health conditions. Researchers reviewed responses from 1999 to 2018 to identify people who survived after a cancer diagnosis and to determine if they had any of 12 functional limitations such as inability to stand for more than an hour, difficulty sitting for more than two hours and difficulty participating in social activities without assistance. Most survivors were women (60.2%) and most were age 65 or older (55.4%).
Some 70% of survivors of cancer reported at least one type of functional limitation, which is twice as much as the general population, the researchers say. The study also found that Hispanic and Black survivors experienced a disproportionate increase in functional limitations during the study period, which could indicate improved access to cancer treatment but poorer quality of survivorship care.