# 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.

## Key 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.