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Advances in the ways that cancer is diagnosed and treated have increased the number of people who live disease-free for long periods of time. This report looks at trends in five-year survival rates for cancer, the time period traditionally associated with good prognosis. However, some people will experience a recurrence of their cancer after five years.
In 2009, more than 12.6 million Americans were alive after having been diagnosed with invasive cancer. Among survivors, more than 2.7 million were living with a previous diagnosis of female breast cancer, more than 2.4 million had been diagnosed with prostate cancer, and more than 1.1 million had been diagnosed with colorectal cancer. More than 2.0 million of 12.6 million Americans diagnosed with invasive cancer were longer-term survivors (16.5 percent) diagnosed at least 20 years earlier.
Five-year relative cancer survival rate: The proportion of patients surviving cancer five years after diagnosis calculated in the absence of other causes of death. This rate is a ratio (expressed as a percentage) of the proportion of observed survivors in a cohort of cancer patients to the proportion of expected survivors. This report shows survival rates for cancers of the prostate, female breast, colon/rectum, and lung. It also shows survival rates for all cancers combined.
All cancer sites combined: Generally rising since 1975, except for a stable period during 1992 to 1995.
Prostate: Generally rising since 1975, except for stable periods during 1992 to 1995 and 1999 to 2003.
Female breast: Rising from 1979 to 1999 and stable from 1999 to 2003.
Colon and rectum: Survival rose during 1975 to1983, followed by a period of non-significant change during 1983 to 1986 and stable survival during 1986 to 1995. Survival then rose during 1995 to 2001 and was stable during 2001 to 2003.
Lung and bronchus: There has been a small but significant rise in survival since 1975. In 2003, five-year survival remained less than 20 percent.
Among the four cancer sites listed above, five-year survival rates are highest for prostate and female breast cancers, intermediate for colorectal cancer, and lowest for lung cancer.
Of the patients diagnosed with cancer (all sites) in 2003, 66.7 percent survived cancer for at least five years. Among those who were children (aged 19 years and younger) at the time of their diagnosis in 2002, 83.9 percent survived cancer for at least five years.
Increase to 72.8 percent the proportion of cancer survivors who are living five years or longer after diagnosis.
Late stage at diagnosis is associated with limited survival. Causes of disparity in late-stage cancer diagnosis vary by site, but may include factors related to low socio-economic status (e.g., health insurance, income, or education) or related demographic attributes (e.g., age, gender, or race and ethnicity minority). This association supports the need for continued development of early detection and stage-appropriate treatment strategies, as well as expanded efforts to ensure that all Americans have equal access to these life-saving interventions.
Improved survival rates result from a combination of early detection, better treatments, and improved supportive care. It is difficult to separate out the contribution of each factor. Caution is also warranted against over-interpretation of improved survival as a result of early detection via screening (lead-time bias).
Despite the positive trends in five-year survival for three of the most common cancers, lung cancer survival rates remain low. Prevention efforts to reduce the incidence of lung cancer would therefore contribute to improvement in overall cancer survival rates for all cancers combined.