BACKGROUND: The authors examined the health‐related quality of life (HRQOL) of cancer survivors between ages 20 and 64 years by using a population‐based survey of individuals who had activity limitations caused by cancer.METHODS: A population‐based, cross‐sectional study was conducted using the 2000 to 2002 Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to examine HRQOL among respondents who reported activity limitations because of cancer. HRQOL was measured by using the CDC's Healthy Days Measures, including self‐rated health status, numbers of unhealthy physical and mental health days, and activity limitation. HRQOL was compared among the following groups: those who reported no activity limitations and those who were limited primarily by cardiovascular conditions, emotional problems, and cancer. Taylor‐series linearization methods were used to calculate population‐based estimates in this complex sample survey.RESULTS: Individuals between ages 20 and 64 years who were limited by cancer reported poorer HRQOL measured as higher prevalence of poor or fair self‐reported health, more physically unhealthy days, more painful days, and more inadequate sleep days. Compared with the group that had no activity limitations, the individuals who had limitations were more likely to be women and to have annual household incomes <$25,000. They were more likely to be unable to work and to have health insurance. In addition, they were more likely to be former smokers and to be overweight, but they were less likely to participate in leisure‐time physical activity.CONCLUSIONS: Overall, respondents between ages 20 and 64 years who reported being limited primarily by cancer reported lower HRQOL. They also reported unhealthy behaviors that were detrimental to improved HRQOL. The HRQOL and lifestyle modification needs of this population need to be examined prospectively to help decrease their burden of suffering. Cancer 2008. Published 2008 by the American Cancer Society.

Background: This report represents a collaborative effort by the major cancer surveillance organizations to present the definitive US statistics for cancer incidence and mortality.Methods: Cancer incidence data were obtained from population‐based cancer registries funded by the Centers for Disease Control and Prevention and the National Cancer Institute and compiled by the North American Association of Central Cancer Registries. Cancer death data were obtained from the National Center for Health Statistics' National Vital Statistics System. Statistics are reported by cancer type, sex, race and ethnicity, and age. The potential impact of the coronavirus disease 2019 (COVID‐19) pandemic on incidence was assessed by using state‐level changes compared with previous years, the stringency of COVID‐19 policy restrictions, the magnitude of COVID‐19 death rates, and changes in the use of mammography.Results: Overall cancer incidence rates per 100,000 were 500 among males and 437 among females. Excluding 2020, cancer incidence rates remained stable (2013–2021) among males and increased 0.3% per year on average (2003–2021) among females. The overall cancer death rate per 100,000 was 173 among males and 126 among females. Cancer death rates decreased by 1.5% per year (2018–2022), slowing from a previous 2.1% decline. Cancer incidence in 2020 declined from prepandemic levels for all demographic groups examined. However, the magnitude of decline was not strongly associated with the study's proxies for health care capacity, health care access, or COVID‐19 policies.Conclusions: Overall cancer mortality declined over 20 years, even during the COVID‐19 pandemic. Disruptions in health care use early in the pandemic resulted in incidence declines in 2020, but 2021 incidence returned to prepandemic levels.

To examine the role of health-related quality of life (HRQOL) in early treatment discontinuation among women enrolled in a breast cancer clinical trial. A total of 464 women were enrolled in the Eastern Cooperative Oncology Group randomized controlled trial of adjuvant regimens comparing six cycles of cytoxan, adriamycin and 5-flurouricil (5-FU) with a 16-week regimen (weekly therapy with cytoxan, adriamycin, vincristine, methotrexate, and 5-FU) among women with lymph node positive breast cancer. One hundred sixty-four women participated in the HrQL substudy using the Breast Chemotherapy Questionnaire, which was designed to measure HRQOL in women receiving chemotherapy. Changes in global HRQOL score were examined over time as a predictor of early treatment discontinuation using generalized estimation equations (GEE) modeling and Cox proportional hazards regression. We considered early treatment discontinuation as a longitudinal binary variable determined at each time point HRQOL was measured. The results of multivariate GEE model fitting indicated that declines in HRQOL (p=0.04), older age (p=0.02), higher degree of nausea (p=0.02), higher degree of neurosensory toxicity (0.03) and lower degrees of hair loss (p=0.004) were correlated with early treatment discontinuation. We then fitted a proportional hazard regression model for time to early discontinuation with HRQOL score as a time-dependent covariate. The results were identical. Declines in HRQOL during therapy predicted early treatment discontinuation even after accounting for age and chemotherapy-related side effects. In the age of ever more aggressive treatments for breast cancer, women's perception of the impact of these treatments on their lives will become more important.

Objectives. We compared breast cancer death rates and mortality trends among American Indian/Alaska Native (AI/AN) and White women using data for which racial misclassification was minimized. Methods. We used breast cancer deaths and cases linked to Indian Health Service (IHS) data to calculate age-adjusted rates and 95% confidence intervals (CIs) by IHS-designated regions from 1990 to 2009 for AI/AN and White women; Hispanics were excluded. Mortality-to-incidence ratios (MIR) were calculated for 1999 to 2009 as a proxy for prognosis after diagnosis. Results. Overall, the breast cancer death rate was lower in AI/AN women (21.6 per 100 000) than in White women (26.5). However, rates in AI/ANs were higher than rates in Whites for ages 40 to 49 years in the Alaska region, and ages 65 years and older in the Southern Plains region. White death rates significantly decreased (annual percent change [APC] = −2.1; 95% CI = −2.3, −2.0), but regional and overall AI/AN rates were unchanged (APC = 0.9; 95% CI = 0.1, 1.7). AI/AN women had higher MIRs than White women. Conclusions. There has been no improvement in death rates among AI/AN women. Targeted screening and timely, high-quality treatment are needed to reduce mortality from breast cancer in AI/AN women.

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. PCD provides an open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention.