Each year the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. A total of 1,658,370 new cancer cases and 589,430 cancer deaths are projected to occur in the United States in 2015. During the most recent 5 years for which there are data (2007-2011), delay-adjusted cancer incidence rates (13 oldest SEER registries) declined by 1.8% per year in men and were stable in women, while cancer death rates nationwide decreased by 1.8% per year in men and by 1.4% per year in women. The overall cancer death rate decreased from 215.1 (per 100,000 population) in 1991 to 168.7 in 2011, a total relative decline of 22%. However, the magnitude of the decline varied by state, and was generally lowest in the South (∼15%) and highest in the Northeast (≥20%). For example, there were declines of 25% to 30% in Maryland, New Jersey, Massachusetts, New York, and Delaware, which collectively averted 29,000 cancer deaths in 2011 as a result of this progress. Further gains can be accelerated by applying existing cancer control knowledge across all segments of the population.

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Cancer statistics, 2015.

The number of cancer survivors continues to increase in the United States because of the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate every 3 years to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries; vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics; and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Data Base are presented for the most prevalent cancer types. Cancer-related and treatment-related short-term, long-term, and late health effects are also briefly described. More than 16.9 million Americans (8.1 million males and 8.8 million females) with a history of cancer were alive on January 1, 2019; this number is projected to reach more than 22.1 million by January 1, 2030 based on the growth and aging of the population alone. The 3 most prevalent cancers in 2019 are prostate (3,650,030), colon and rectum (776,120), and melanoma of the skin (684,470) among males, and breast (3,861,520), uterine corpus (807,860), and colon and rectum (768,650) among females. More than one-half (56%) of survivors were diagnosed within the past 10 years, and almost two-thirds (64%) are aged 65 years or older. People with a history of cancer have unique medical and psychosocial needs that require proactive assessment and management by follow-up care providers. Although there are growing numbers of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based resources are needed to optimize care.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21565

Cancer treatment and survivorship statistics, 2019

Binge eating disorder (BED) is characterized by recurrent episodes of binge eating and, subsequently, significant psychological distress (e.g., shame, guilt). Recently recognized by the American Psychiatric Association (APA) as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BED is considered a significant public health problem independently and for its impact on obesity and diabetes. The related problem, loss-of-control (LOC) eating, describes recurrent binge-like eating behavior in individuals who cannot meet full criteria for BED such as post-bariatric surgery patients and children. LOC eating has detrimental psychological and physical health effects, including significant distress and symptoms of depression, as well as excess weight gain in children and suboptimal weight loss and weight regain in post-bariatric patients. Table 1 lists the diagnostic criteria for BED (as defined in the current DSM-5 and earlier, in the DSM, Fourth Edition [DSM-IV]) and frequently-used definitions of LOC eating.

Diagnostic and statistical manual of mental disorders, fifth edition

Importance Understanding skin cancer incidence is critical for planning prevention and treatment strategies and allocating medical resources. However, owing to lack of national reporting and previously nonspecific diagnosis classification, accurate measurement of the US incidence of nonmelanoma skin cancer (NMSC) has been difficult. Objective To estimate the incidence of NMSC (keratinocyte carcinomas) in the US population in 2012 and the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in the 2012 Medicare fee-for-service population. Design, Setting, and Participants This study analyzes US government administrative data including the Centers for Medicare & Medicaid Services Physicians Claims databases to calculate totals of skin cancer procedures performed for Medicare beneficiaries from 2006 through 2012 and related parameters. The population-based National Ambulatory Medical Care Survey database was used to estimate NMSC-related office visits for 2012. We combined these analyses to estimate totals of new skin cancer diagnoses and affected individuals in the overall US population. Main Outcomes and Measures Incidence of NMSC in the US population in 2012 and BCC and SCC in the 2012 Medicare fee-for-service population. Results The total number of procedures for skin cancer in the Medicare fee-for-service population increased by 13% from 2 048 517 in 2006 to 2 321 058 in 2012. The age-adjusted skin cancer procedure rate per 100 000 beneficiaries increased from 6075 in 2006 to 7320 in 2012. The number of procedures in Medicare beneficiaries specific for NMSC increased by 14% from 1 918 340 in 2006 to 2 191 100 in 2012. The number of persons with at least 1 procedure for NMSC increased by 14% (from 1 177 618 to 1 336 800) from 2006 through 2012. In the 2012 Medicare fee-for-service population, the age-adjusted procedure rate for BCC and SCC were 3280 and 3278 per 100 000 beneficiaries, respectively. The ratio of BCC to SCC treated in Medicare beneficiaries was 1.0. We estimate the total number of NMSCs in the US population in 2012 at 5 434 193 and the total number of persons in the United States treated for NMSC at 3 315 554. Conclusions and Relevance This study is a thorough nationwide estimate of the incidence of NMSC and provides evidence of continued increases in numbers of skin cancer diagnoses and affected patients in the United States. This study also demonstrates equal incidence rates for BCC and SCC in the Medicare population.

https://jamanetwork.com/journals/jamadermatology/articlepdf/2281227/doi150020.pdf

Incidence Estimate of Nonmelanoma Skin Cancer (Keratinocyte Carcinomas) in the US Population, 2012

Cost Effectiveness in Health and Medicine.

https://stacks.cdc.gov/view/cdc/52400/cdc_52400_DS1.pdf

Breast Cancer in Young Women: Health State Utility Impacts by Race/Ethnicity.

Sun exposure in childhood is an important risk factor for the future development of skin cancer. The risk of developing melanoma is strongly related to a history of sunburns (an indicator of intense UV radiation exposure) during childhood and adolescence.1 However, skin cancer risk can be greatly reduced if children and adolescents are protected from UV radiation, suggesting the importance of protecting young people from the sun beginning at an early age.1 Given the amount of time children spend in school settings, schools can play an important role in protecting children and adolescents from UV exposure and the future development of skin cancer.1,2 Skin cancer prevention can be addressed in schools through policy and environmental changes and educational programs.2 School-based efforts to change children’s knowledge, attitudes, and behaviors regarding sun protection can play a vital role in saving lives, improving quality of life, and reducing avoidable costs from the treatment of skin cancers. Acknowledging the critical role of schools, key strategies outlined in the Surgeon General’s Call to Action to Prevent Skin Cancer2 include increasing the availability of sun protection in educational settings and supporting the inclusion of sun protection in school policies, construction of school facilities, and school curricula. The Guide to Community Preventive Services (The Community Guide)3 specifically recommends interventions to prevent skin cancer in primary and middle schools as well as child care centers, based on strong evidence of their effectiveness in increasing sun-protective behaviors and decreasing UV exposure, sunburn incidence, and formation of new moles. Recommended interventions to promote sunprotective behaviors include educational interventions, supportive behavioral interventions, and environmental and policy changes.3 Educational and behavioral interventions include teaching children about sun safety and the effects of UV radiation. Environmental and policy changes include increasing the availability of sun protection (eg, sunscreen, sun-protective clothing), increasing the availability of shade, and implementing sunprotection policies (eg, clothing guidelines, restrictions on outdoor activities during peak sunlight hours).3 Despite these recommendations and evidence of their effectiveness in preventing skin cancer, findings of the Centers for Disease Control and Prevention4,5 reveal that the use of these policies and practices in schools throughout the United States remains low. The Centers for Disease Control and Prevention’s School Health Policies and Practices Study (SHPPS)6 is a national survey periodically conducted to assess school health policies and practices. The SHPPS collected data on policies and practices related to sun safety at the state and district levels in 2012, and on sun safety–related information at the school level in 2014.6 The SHPPS data from 20124 indicate that most states and school districts do not have policies in place to support skin cancer prevention, and most school districts neither recommend nor require sunsafety strategies for their students. At the state level, only 31% of states developed, revised, or assisted in developing model policies, policy guidance, or other materials; 32% of states distributed or provided such materials to district or school staff; 25% of states (and only 18% of school districts) provided funding for professional development or offered professional development on how to implement schoolwide policies and programs during the 2 years before the study; and 42% of states provided technical assistance to district or school staff during the 12 months before the study.4 Moreover, very few schools required and only 25% to 44% of schools recommended certain sun-safety strategies in schools,4 such as allowing students to apply sunscreen while at school, encouraging students to wear hats or visors when in the sun during the school day, encouraging students to wear protective clothing (eg, long sleeve shirts or long pants) when in the sun during the school day, encouraging students to wear sunglasses when in the sun during the school day, and scheduling outdoor activities to avoid times when the sun is at peak intensity during the school day. According to the 2014 school-level data (Table),5 almost half (48%) of schools allow students time to apply sunscreen at school, and 66% teach about sun safety or skin cancer prevention as part of required instruction. Other sun-safety practices are generally uncommon in US schools, representing missed opportunities for prevention. Previous research has found the most common reasons for not having a policy are lack of awareness of school leadership and organizational barriers at the school distrct.7 Many school principals have indicated their willingness to develop skin cancer prevention policies but were unaware of skin cancer as a health problem or the role they could play in prevention.7 Some schools have practices that may create barriers to sun safety for students. For example, some schools prohibit students from wearing hats or visors (8%) or sunglasses (7%) when in the sun during the school day (Table). In addition, school policies about over-the-counter drugs that prohibit the use of sunscreen or require application by a school nurse may also limit students’ ability to use sun protection.2 Previous research found that nearly half of schools required a physician prescription before staff could apply sunscreen to students.7 It is important to identify and address these barriers to skin cancer prevention in schools, as these policies may create barriers to ensuring adequate sun protection during outdoor school activities. VIEWPOINT

/pdf/the-important-role-of-schools-in-the-prevention-of-skin-3klcwcpvwo.pdf

The Important Role of Schools in the Prevention of Skin Cancer.

Emergency Department Visits Involving Opioid Overdoses, U.S., 2010–2014

Evidence-based information for nurses on the risks and benefits of prescription opioids.

/pdf/opioid-prescribing-in-the-united-states-40im2nq09j.pdf

Opioid Prescribing in the United States.

Purpose
Younger women (under age 45 years) diagnosed with breast cancer often face more aggressive tumors, higher treatment intensity, lower survival rates, and greater financial hardship. The purpose of this study was to estimate breast cancer costs by stage at diagnosis during the first 18 months of treatment for privately insured younger women.

/pdf/breast-cancer-treatment-costs-in-younger-privately-insured-54f1f1pqf4.pdf

Gery P. Guy

Papers

Breast Cancer in Young Women: Health State Utility Impacts by Race/Ethnicity.

The Important Role of Schools in the Prevention of Skin Cancer.

Emergency Department Visits Involving Opioid Overdoses, U.S., 2010–2014

Opioid Prescribing in the United States.

Breast cancer treatment costs in younger, privately insured women.