Prevalence and trends in long-term survivors of early-onset vs. late-onset cancer: a serial cross-sectional study

TL;DR

This study shows that cancer survivorship rates have increased over 27 years for both early- and late-onset cancers, with notable differences by gender and socioeconomic factors.

Contribution

The study reveals distinct trends in cancer survivorship by age at diagnosis, gender, and socioeconomic status over a 27-year period.

Findings

Both early-onset and late-onset cancer survivorship rates increased significantly from 1997 to 2023.

Male early-onset cancer survivors showed the sharpest increase compared to other groups.

High-income groups had higher prevalence and faster growth in cancer survivorship.

Abstract

With increasing global cancer survivorship, understanding differential trends by age at diagnosis is crucial for developing targeted care strategies. This study examines 27-year trends in early-onset (20–49 years) vs. late-onset (≥50 years) cancer survivorship in the US population.

We analyzed nationally representative data from the National Health Interview Survey (1997–2023), identifying adults surviving ≥5 years post-diagnosis. Weighted prevalence estimates were calculated, and temporal trends were analyzed using Joinpoint regression to compute average annual percentage changes (AAPCs) with 95% confidence intervals (CIs).

Women represented 72.7% of early-onset cancer survivors, compared to 51.5% of late-onset cancer survivors. From 1997 to 2023, both prevalence of early-onset (AAPC 1.7, 95% CI: 1.4 to 2.0) and late-onset (AAPC 1.9, 95% CI: 1.7 to 2.1) cancer survivors increased significantly. The prevalence of male early-onset cancer survivors rose the most sharply (AAPC 3.1, 95% CI: 2.5 to 3.8), compared to prevalence of late-onset (AAPC 1.9, 95% CI: 1.6 to 2.3) or female cancer survivors (AAPC early-onset 1.3, 95% CI: 1.0 to 1.6; late-onset 1.7, 95% CI: 1.5 to 2.0). College-educated individuals had higher baseline prevalence and faster growth. Similarly, high-income groups showed elevated prevalence (early-onset 2.65%; late-onset 8.22%) and the most rapid increase was found in late-onset cancer survivors (AAPC 3.2, 95% CI: 2.5 to 3.9).

These findings demonstrate universal increases in cancer survivorship with distinct socioeconomic and gender patterns, highlighting the need for tailored survivorship programs and targeted policies to address emerging disparities in long-term cancer care.

Figures