Cancer survivors and chronic disease : North Carolina 2009

QJJ[o)(°]sG® Cancer Survivors and Chronic Disease — North Carolina 2009 Background Approximately 12 million adults in the U.S. are cancer survivors,1 and this estimate could double by 2050. 2 Due to medical advances in early detection and treatment, people with cancer are living longer than ever before. Two-thirds of adults with cancer are now expected to live at least five years after being diagnosed.1 Even among women with breast cancer, the five-year survival rates have improved dramatically. In 1975, 75.0 percent of women were still alive five years after a diagnosis of breast cancer; in 2002, the five- year survival rate for breast cancer was 90.6 percent.3 However, a potential downside to increased longevity among cancer survivors are potential side effects of cancer treatment, resulting from chemotherapy, radiation or surgery. These “late effects” can become apparent a few months or years after treatment has ended. J Late effects can include heart or kidney problems; lung problems, which can cause difficulty breathing; memory problems; infertility; vision or hearing loss; and an increased risk of future cancers.4 Consequently, cancer survivors have an increased risk of developing adverse health conditions and/or chronic disease. This report examines the occurrence of chronic disease among cancer survivors, using the results from the 2009 North Carolina Behavioral Risk Factor Surveillance System (BRFSS). Methods Cancer status was classified by response to the 2009 BRFSS Core question from the Cancer Survivors Module: “I lave you ever been told by a doctor, nurse, or other health professional that you had cancer?” Cancer survivors and adults who reported no history of a cancer diagnosis (without cancer) were compared on demographic characteristics and prevalence of chronic diseases and health conditions. Cochran-Mantel-Haenszel age-adjusted relative risks were calculated to assess the excess risk of chronic disease among cancer survivors. In this case, the relative risk is the ratio of the prevalence of chronic disease occurring among cancer survivors versus those without cancer. Results are based on 1 2 ,6 1 5 adults who answered the question about ever being diagnosed with cancer. Results Ten percent of respondents (N=1906) reported having been diagnosed with cancer. Comparisons on demographic characteristics by cancer status (Table 1 ) revealed that levels of education and income did not vary substantially by cancer status. Among cancer survivors, female respondents were more likely to report being Table 1 Demographic Characteristics By Cancer Status: 2009 NC BRFSS Survey (N = 12,615) Cancer Status Cancer Survivors Without Cancer Demographics N % N % Sex Males 663 39.4 4,042 49.6 Females 1,243 60.6 6.667 50.4 Total 1,906 100.0 10.709 100.0 Лее 18-44 133 13.1 3,267 52.7 45-54 237 17.0 2,205 19.2 55-64 405 23.6 2,267 14.5 65-74 565 22.9 1.697 8.1 75+ 551 23.3 1,187 5.5 Total 1,891 100.0 10,623 100.0 Race White 1,684 84.8 8,346 70.2 African American 147 11.0 1,582 19.4 Other 68 4.2 705 10.4 Total 1,899 100.0 10.633 100.0 Education Less than H.S 260 11.4 1,351 13.9 High School 548 29.7 3.174 28.7 Post High School 480 24.1 2,737 26.3 College or More 616 34.7 3,431 31.1 Total 1,904 100.0 10,693 100.0 Income <$15.000 239 11.7 1,130 11.3 $15,000-24,999 316 17.1 1.679 17.4 $25.000-34,999 213 13.3 1.087 11.0 $35.000-49.999 252 15.5 1.383 13.4 $50.000+ 575 42.4 3,868 46.9 Total 1,595 100.0 9,147 100.0 Employment Employed 545 34.3 5,499 58.3 Out of Work 77 6.3 809 10.0 Other/retired 1.081 48.9 3,560 25.3 Unable to Work 201 10.5 825 6.4 Total 1.904 100.0 10,709 100.0 The Behavioral Risk Factor Surveillance System (BRFSS) is a random telephone health survey of non-institutionalized adults aged 18 and older in households sponsored by the Centers for Disease Control and Prevention (CDC). The North Carolina BRFSS operates through the State Center for Health Statistics' Survey Center, Division of Public Health, conducting interviews monthly in both Fnglish and Spanish. Beginning in January 2009, the CDC introduced three questions in the Core Section of the survey on cancer survivors. The questions pertained to ever-diagnosed with cancer, how many different types of cancer, and respondent age at diagnosis. In addition, the CDC also sponsored an optional module on cancer survivorship, containing 10 questions ranging from treatment to health insurance coverage for cancer. For more detailed information, please visit the NC-BRFSS Web site at www.schs.state.nc.us/SCHS/brfss or contact the BRFSS Coordinator at (919) 855-4485.