What CDC Is Doing About Cancer Survivorship

A cancer survivor is a person who has been diagnosed with cancer from the time of diagnosis throughout his or her life. People in their lives who are affected by the diagnosis, including family members, friends, and caregivers, also are recognized as an important part of the cancer survivorship experience. As the population of cancer survivors continues to grow, the public health community is considering ways to address the issues related to survivorship. CDC works with public, non-profit, and private partners to create and implement successful strategies to help the millions of people in the United States live with, through, and beyond cancer.

National Action Plan

In 2004, CDC's Division of Cancer Prevention and Control (DCPC) and LIVESTRONG (formerly the Lance Armstrong Foundation), along with nearly 100 experts in cancer survivorship and public health, released A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies. This collaboration articulated goals, activities, and priorities to address the issues facing the growing number of cancer survivors in the United States.

DCPC has joined forces with national organizations, states, tribes, territories, and Pacific Island Jurisdictions to address several of the cancer survivorship "priority needs" cited in the Action Plan. This work includes efforts to understand and improve care and quality of life for cancer patients, their family, friends, and caregivers, as well as initiatives to increase survivorship in underserved populations.

Funded Partnerships

CDC supports the development and distribution of cancer survivorship materials and through funded partnerships.

Research

Research conducted by DCPC investigators has shown that—

• There are differences in non-Hodgkin lymphoma survival between young adults and children.¹
• Primary care providers provide the majority of care to men and women who have survived cancer more than five years, and need guidance regarding late effects related to cancer.²
• Cancer survivors were more likely to make positive than negative behavior changes after cancer.³
• Various organizations and programs are striving to address the needs of cancer survivors through public health planning, yet challenges exist in understanding and serving survivors.^{4 5}
• Survivors often have difficulty finding information to address their social and financial concerns after cancer diagnosis and treatment. Patients desire clear and easy-to-follow information on the long-term implications of treatment and disease.⁶

Ongoing Work

DCPC's cancer survivorship activities include—

• Providing technical assistance, resources, partnerships, and guidance to comprehensive cancer control programs and coalitions as survivorship-related activities are initiated, including creating survivorship-related cancer plan objectives, statewide survivorship resource guides, and conference support.
• Analyzing health, behavioral, and quality of life data for cancer survivors using population-based national surveys such as the Behavioral Risk Factor Surveillance System and the National Health Interview Survey to assess the burden of cancer survivors and to plan, implement, and evaluate cancer control strategies.
• Studying various aspects of survivorship, including—
• Assessing the feasibility of completing a survivorship care plan for cancer patients that summarizes diagnosis, treatment, coordination of future care, and availability of local support.
• Identifying the barriers to receiving appropriate follow-up care and practicing healthy behaviors after cancer treatment.
• Estimating the number of breast cancer survivors who may be at risk for infertility because of their cancer treatment.
• Conducting systematic literature reviews to understand issues related to breast and ovarian cancer and its treatment, such as financial, family, psychosocial, and information concerns and treatment decisions.

Future Directions

DCPC would like to expand its research and programmatic initiatives to meet the emerging challenges of cancer survivorship by—

• Assisting states, tribal groups, territories, and Pacific Island Jurisdictions in their efforts to address cancer survivorship through Comprehensive Cancer Control initiatives.
• Developing ways to evaluate success by defining outcomes in improving survivorship.
• Enhancing resources, partnerships, and coordination among national and community organizations that serve survivors, including their family members, caregivers, and health care providers.
• Investigating factors that impact receipt of appropriate follow-up and care coordination among cancer survivors, including low-income and medically underserved populations.

More Information

For more information, please read Addressing cancer survivorship through public health: An update from the Centers for Disease Control and Prevention.

References

¹Tai E, Pollack LA, Townsend J, Li J, Steele CB, Richardson LC. Differences in non-Hodgkin lymphoma survival between young adults and children. Archives of Pediatrics and Adolescent Medicine 2010;164(3):218–224.

²Hawkins NA, Smith T, Zhao L, Rodriguez J, Berkowitz Z, Stein KD. Health-related behavior change after cancer: results of the American Cancer Society's studies of cancer survivors (SCS). Journal of Cancer Survivorship 2010;4(1):20–32.

³Pollack LA, Adamache W, Ryerson AB, Eheman CR, Richardson LC. Care of long-term cancer survivors: physicians seen by Medicare enrollees surviving longer than 5 years. Cancer 2009;115(22):5284–5295.

⁴Pollack LA, Greer GE, Rowland JH, Miller A, Doneski D, Coughlin SS, Stovall E, Ulman D. Cancer survivorship: A new challenge in comprehensive cancer control. Cancer Causes and Control 2005;16(S1):51–59.

⁵Centers for Disease Control and Prevention. Cancer survivorship—United States, 1971–2001. MMWR 2004;53:526–529.

⁶Hawkins NA, Pollack LA, Leadbetter S, Steele WR, Carroll J, Dolan JG, Ryan EP, Ryan JL, Morrow GR. Informational needs of patients and perceived adequacy of information available before and after treatment of cancer. Journal of Psychosocial Oncology 2008;26(2):1–16.