Cancer survivors rarely receive the specialized follow-up care they need, according to a report released by the Institute of Medicine and National Research Council of the National Academies.
The report, From Cancer Patient to Cancer Survivor: Lost in Transition, reveals that inconstant or poor follow-up care can delay detection of new or recurring cancer or long-term side effects from previous treatments cancer treatments themselves can leave patients at risk for long-term health problems; and that cancer survivors face other long-term health risks, including psychosocial problems.
According to the 536-page IOM report, poor insurance coverage is a major reason for inadequate follow-up visits. More than 20 percent of cancer survivors are 65 or older, and Medicare is the primary payer for cancer survivors.
The report recommends a personalized survivorship care plan to optimize patients' health and quality of life after treatment and recovery. The plan should include
- copies of all medical records and summary of treatments;
- summary of cancer history, including onset, treatment, medication doses and outcome;
- information about potential long-term effects of treatment and detection guidelines;
- specific instructions for timing and nature of follow-up care; and
- legal protection information and health insurance coverage.
In somewhat more promising cancer news, a study published in the Oct. 5 Journal of the National Cancer Institute reported that the risk of dying from cancer continues to decline and that the rate of detection of new cancers has leveled. Researchers found death rates from all cancer forms dropped 1.1 percent annually from 1993 to 2002. While the decline is thought to reflect overall progress in prevention, early detection and treatment, not all U.S. demographics shared equally in these declines.
According to the "Annual Report to the Nation on the Status of Cancer, 1975-2002," collective death rates from all cancers decreased 1.5 percent per year from 1993 to 2002 in men and 0.8 percent in women. Lung cancer remained the leading fatal cancer for both genders, but death rates decreased in 12 of the 15 most often fatal cancers in men and nine of the top 15 in women.
From 1992 to 2002, prostrate, lung and colon/rectum cancers accounted for the most fatalities in men, and breast, colon/rectum and lung cancers were most deadly among women; those figures pertained across all racial and ethnic populations. Rates of lung and prostate cancers decreased in men across all demographics.
Breast cancer incidence rates increased in Asian/Pacific Islander women, decreased among American Indian/Alaska Native women and were stable for other demographics. Colorectal cancer incidence rates decreased only among white men and women. Black men had 25 percent higher incidence rates and 43 percent higher mortality rates than white men for all forms of cancer combined.
