Cancer Diagnoses to Increase Among Minorities, Elderly

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By Bayan Raji, Staff Writer

Cancer among elderly people and minority groups is expected to increase dramatically over the next 30 years, precipitating a need for increased research in two groups that often are under-represented in clinical trials.

The study by researchers at M. D. Anderson, published in the June issue of Journal of Clinical Oncology, predicts cancer diagnoses over the next 30 years.

Population, cancer cases will grow

To conduct their research, the team looked at U.S. Census Bureau statistics, updated in 2008 to project population growth through 2050, and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database.

They found:
•    The U.S. population is expected to grow from 305 million in 2010 to 365 million in 2030
•    The total number of cancer diagnoses per year will increase from 1.6 million in 2010 to 2.3 million in 2030
•    In 2030, 70% of cancers will be diagnosed in the elderly
•    In 2030, 28% of cancers will be diagnosed in minorities

The study highlighted three important issues:
•    Clinical trial participation
•    Increasing cost of cancer care
•    Expected shortage of oncologists

Groups face challenges

From 2010 to 2030, the rate of cancer is predicted to increase:

•    65% in elderly people
•    100% percent in non-white people

These groups are under-represented in clinical studies and are vulnerable to sub-optimal cancer treatment.

"The fact that these two groups have been under-represented in clinical research participation, combined with the groups' rapid growth in cancer diagnoses, reflects the need for clinical trials of new therapies to be more inclusive and to address issues that are relevant to both populations," says Ben Smith, M.D., adjunct assistant professor in M. D. Anderson's Department of Radiation Oncology and the study's senior author.

Screening, prevention crucial

Cancer rates will increase by:

•    31% in whites
•    64% in blacks
•    76% in American Indian-Alaska Natives
•    101% in multi-racial people
•    132% in Asian-Pacific Islanders
•    142% in Hispanics

Screening and prevention will become essential tools to help prevent a similar growth in cancer deaths. However, no easy answer exists, according to Smith.
"There's no doubt the increasing incidence of cancer is a very important societal issue," Smith says. "There will not be one solution to this problem, but many different issues that must be addressed to prepare for these changes."
Changes take toll on system

The cost of cancer care continues to grow at a rate that's not sustainable for patients.

"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," Smith says. "These are two issues that oncologists need to be much more concerned about and attuned to."

A shortage of medical oncologists will have an impact on the health care system by 2020, according to the American Society for Clinical Oncology (ASCO).  

Smith says ASCO and other professional medical organizations beyond oncology are aware of the problem and are trying to increase the number of physicians, nurse practitioners and physician assistants.

More research needed

Unless specific prevention and treatment strategies are discovered, cancer death rates will increase dramatically, according to Smith.

"It's alarming that a number of the types of cancers expected to increase, such as liver, stomach and pancreas, still have tremendously high mortality rates," he says.

M. D. Anderson resources

Audio Interview with Dr. Smith about Cancer Rate Growth (Cancer Newsline)

Cancer Incidence Rates Among Minorities Expected to Increase (David Wetter, Ph.D)

Division of Radiation Oncology

Other resources

Cancer Health Disparities (National Cancer Institute)

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