Cancer Survivorship: State Policy Issues

Published 2006

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Introduction

A diagnosis of cancer once almost certainly meant a death sentence. Although it remains the nation’s second leading cause of death, many cancers now are treatable if detected early. According to the American Cancer Society, about 564,830 Americans are expected to die of cancer in 2006. This is equal to more than 1,500 people per day. This disease is common enough that about 43 percent of American males and 39 percent of American females will be diagnosed with some type of cancer in their lifetimes. Although variations exist by cancer type, the relative survival rate of people with cancer has increased from 50 percent between 1974 and 1976 to 64 percent between 1995 and 2000.¹ Advancements in screening and treatment technologies enable earlier detection and more successful treatment options for people who have been recently diagnosed.

U.S. cancer death rates are highest among African Americans, compared with other racial and ethnic groups, primarily because of lack of access to early detection and treatment services. Figure 1 illustrates incidence of cancer in the United States.

More than 10 million cancer survivors live in the United States today—three times the number who were alive 30 years ago. Many survivors and their families experience long-term physical, emotional and practical needs resulting from cancer that affect their quality of life. Because people now are surviving longer after cancer diagnosis and treatment, cancer is less likely to be a death sentence, although it remains a difficult experience. Advances in treatment options and early detection have played roles in allowing those with cancer to lead full lives during and after treatment. The cancer “survivorship” concept includes the physical, emotional and practical issues that come during and after a cancer diagnosis.

However, more people face the rest of their lives with a new perspective and new challenges associated with being a cancer survivor. Everyday situations may be more difficult for those with a cancer history. For example, insurance companies may deny individuals coverage for cancer-related illnesses if these illnesses are deemed “preexisting conditions.” Special diagnostic tests for cancer may have higher copayments than regular doctor visits or testing procedures. Survivors may need time off from work for continued treatments to prevent cancer reoccurrence or manage pain. All these issues and others make a cancer diagnosis even more difficult to manage.

Policymakers who are aware of these cancer survivorship issues are better able to make informed policy decisions. The topics in this booklet provide some examples of key policy issues related to cancer survivors:

Cancer as a Chronic Disease
Comprehensive Cancer Control Plans
Health Insurance
Employment
Pain Management Policies
Support, Family and Infertility Issues
End-of-Life Issues

For additional information and legislative examples, see www.ncsl.org/programs/health/cancersurv.htm.

Resources

The American Cancer Society, www.cancer.org.

The Centers for Diseases and Control, www.cdc.gov/cancer/index.htm.

The Lance Armstrong Foundation inspires and empowers people affected by cancer. The LAF services its mission through advocacy, public health and research, www.livestrong.org.

The National Cancer Institute Office of Cancer Survivorship, http://dccps.nci.nih.gov/ocs/.

National Conference of State Legislatures, cancer policy and information website, www.ncsl.org/programs/health/cancerweb.htm.