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Journal of Cancer Survivorship

, Volume 8, Issue 4, pp 611–617 | Cite as

Health status, use of healthcare, and socio-economic implications of cancer survivorship in Portugal: results from the Fourth National Health Survey

  • Luís Pacheco-Figueiredo
  • Nuno Lunet
Article

Abstract

Purpose

Understanding the morbidity and socio-economic implications of cancer survivorship is essential for a comprehensive management of oncological diseases. We compared cancer survivors (CS) with the general population regarding health status, use of healthcare resources and socio-economic condition.

Methods

We analyzed data from a representative sample of the Portuguese population aged ≥15 years (n = 35,229). We defined three groups of CS, according to the time since diagnosis and the latest cancer treatment: CS 1 diagnosis within 12 months of interview; CS 2 diagnosis more than 12 months before and treatment in the previous 12 months; CS 3 diagnosis and treatment more than 12 months before. These were compared with the general population, adjusting for differences in sex, age, and place of residence.

Results

The prevalence of CS was 2.2 % (CS 1: 0.2 %; CS 2: 0.9 %, CS 3: 1.1 %). Self-perceived health status was worse among CS and short-time incapacity more frequent among CS 1 and CS 2. Health expenses were higher in the early stages of survivorship. Lower household income and financial difficulties were more frequent in CS 1 and CS 3 men, respectively.

Conclusion

This study confirmed the higher consumption of healthcare resources and worse financial situation among CS.

Implications for Cancer Survivors

Our study provides valuable information for understanding the global impact of cancer survivorship.

Keywords

Neoplasms Survival Health survey Portugal 

Notes

Acknowledgments

The authors thank the National Health Systems Observatory (Observatório Nacional de Saúde), National Institute of Health Dr. Ricardo Jorge (INSA), Ministry of Health and the National Institute of Statistics (INE) for providing the data (Ministério da Saúde, Instituto Nacional de Saúde Dr. Ricardo Jorge; IP, Departamento de Epidemiologia/Instituto Nacional de Estatística: Inquérito Nacional de Saúde 2005/2006). Luís Pacheco-Figueiredo received a grant from the Fundação para a Ciência e a Tecnologia (SFRH/SINTD/60124/2009).

Conflict of interest

Luís Pacheco-Figueiredo and Nuno Lunet declare that they have no conflicts of interest.

References

  1. 1.
    Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49(6):1374–403. doi: 10.1016/j.ejca.2012.12.027.CrossRefPubMedGoogle Scholar
  2. 2.
    Edwards BK, Howe HL, Ries LA, Thun MJ, Rosenberg HM, Yancik R, et al. Annual report to the nation on the status of cancer, 1973–1999, featuring implications of age and aging on U.S. cancer burden. Cancer. 2002;94(10):2766–92.CrossRefPubMedGoogle Scholar
  3. 3.
    Araujo F, Gouvinhas C, Fontes F, La Vecchia C, Azevedo A, Lunet N. Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980–2010). Eur J Prev Cardiol. 2013. doi: 10.1177/2047487313497864.Google Scholar
  4. 4.
    Amaro J, Severo M, Vilela S, Fonseca S, Fontes F, La Vecchia C, et al. Patterns of breast cancer mortality trends in Europe. Breast. 2013;22(3):244–53. doi: 10.1016/j.breast.2013.02.007.CrossRefPubMedGoogle Scholar
  5. 5.
    Fontes F, Severo M, Castro C, Lourenco S, Gomes S, Botelho F, et al. Model-based patterns in prostate cancer mortality worldwide. Br J Cancer. 2013;108(11):2354–66. doi: 10.1038/bjc.2013.217.PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide [database on the Internet]. Lyon, France: International Agency for Research on Cancer. 2013. Available from: http://globocan.iarc.fr. Accessed 11 Nov 2013.
  7. 7.
    Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R, et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol. 2008;9(8):730–56. doi: 10.1016/S1470-2045(08)70179-7.CrossRefPubMedGoogle Scholar
  8. 8.
    Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R. EUROCARE-4. Survival of cancer patients diagnosed in 1995–1999. Results and commentary. Eur J Cancer. 2009;45(6):931–91.CrossRefPubMedGoogle Scholar
  9. 9.
    SEER Cancer Statistics Review, 1975–2010 [database on the Internet]. National Cancer Institute. 2013. Available from: http://seer.cancer.gov/csr/1975_2010/. Accessed 11 Nov 2013.
  10. 10.
    RORENO. Sobrevivência Global, Doentes diagnosticados em 2005–06—Região Norte. Registo Oncológico Regional do Norte. 2013;Instituto Português de Oncologia do Porto, ed. Porto, 2013.Google Scholar
  11. 11.
    CDC, Prevention CfDCa. Surveillance of demographic characteristics and health behaviours among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR; 2012.Google Scholar
  12. 12.
    Hewitt M, Greenfield S, Stovall E, Editors. From cancer patient to cancer survivor: lost in transition. Committee on Cancer Survivorship: Improving Care and Quality of Life, Institute of Medicine and National Research Council; 2006.Google Scholar
  13. 13.
    Shi Q, Smith TG, Michonski JD, Stein KD, Kaw C, Cleeland CS. Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s studies of cancer survivors. Cancer. 2011;117(12):2779–90. doi: 10.1002/cncr.26146.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    INE, INSA. Inquérito Nacional Saúde 2005/2006. Instituto Nacional Estatística, Instituto Nacional Ricardo Jorge; 2009. p. 1–330.Google Scholar
  15. 15.
    Coutinho LM, Scazufca M, Menezes PR. Methods for estimating prevalence ratios in cross-sectional studies. Rev Saude Publica. 2008;42(6):992–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Cancer prevalence statistics: approaches to estimation using cancer registry data. [database on the Internet]. Bethesda, MD: National Cancer Institute (NCI). 2010. Available from: http://srab.cancer.gov/prevalence/approaches.html. Accessed: March 4, 2011.
  17. 17.
    Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, et al. Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer. 2009;101(3):541–7. doi: 10.1038/sj.bjc.6605148.PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide [database on the Internet]. Lyon, France: International Agency for Research on Cancer. 2010. Available from: http://globocan.iarc.fr. Accessed 9 Nov 2013.
  19. 19.
    Desai MM, Bruce ML, Desai RA, Druss BG. Validity of self-reported cancer history: a comparison of health interview data and cancer registry records. Am J Epidemiol. 2001;153(3):299–306.CrossRefPubMedGoogle Scholar
  20. 20.
    Fu OS, Crew KD, Jacobson JS, Greenlee H, Yu G, Campbell J, et al. Ethnicity and persistent symptom burden in breast cancer survivors. J Cancer Survivorship Res Pract. 2009;3(4):241–50. doi: 10.1007/s11764-009-0100-7.CrossRefGoogle Scholar
  21. 21.
    Kuhnt S, Ernst J, Singer S, Ruffer JU, Kortmann RD, Stolzenburg JU, et al. Fatigue in cancer survivors—prevalence and correlates. Onkologie. 2009;32(6):312–7. doi: 10.1159/000215943.CrossRefPubMedGoogle Scholar
  22. 22.
    Treanor C, Donnelly M. An international review of the patterns and determinants of health service utilisation by adult cancer survivors. BMC Health Serv Res. 2012;12:316. doi: 10.1186/1472-6963-12-316.PubMedCentralCrossRefPubMedGoogle Scholar
  23. 23.
    Snyder CF, Frick KD, Kantsiper ME, Peairs KS, Herbert RJ, Blackford AL, et al. Prevention, screening, and surveillance care for breast cancer survivors compared with controls: changes from 1998 to 2002. J Clin Oncol Off J Am Soc Clin Oncol. 2009;27(7):1054–61. doi: 10.1200/JCO.2008.18.0950.CrossRefGoogle Scholar
  24. 24.
    Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96(17):1322–30. doi: 10.1093/jnci/djh255.CrossRefPubMedGoogle Scholar
  25. 25.
    Travis LB. The epidemiology of second primary cancers. Cancer Epidemiol, Biomark Prev Publ Am Assoc Cancer Res Am Soc Prev Oncol. 2006;15(11):2020–6. doi: 10.1158/1055-9965.EPI-06-0414.CrossRefGoogle Scholar
  26. 26.
    Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101(8):1712–9. doi: 10.1002/cncr.20560.CrossRefPubMedGoogle Scholar
  27. 27.
    Snyder CF, Frick KD, Peairs KS, Kantsiper ME, Herbert RJ, Blackford AL, et al. Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study. J Gen Intern Med. 2009;24(4):469–74. doi: 10.1007/s11606-009-0903-2.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Cooper GS, Yuan Z, Chak A, Rimm AA. Patterns of endoscopic follow-up after surgery for nonmetastatic colorectal cancer. Gastrointest Endosc. 2000;52(1):33–8. doi: 10.1067/mge.2000.106685.CrossRefPubMedGoogle Scholar
  29. 29.
    Earle CC, Burstein HJ, Winer EP, Weeks JC. Quality of non-breast cancer health maintenance among elderly breast cancer survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21(8):1447–51. doi: 10.1200/JCO.2003.03.060.CrossRefGoogle Scholar
  30. 30.
    Yabroff KR, Short PF, Machlin S, Dowling E, Rozjabek H, Li C, et al. Access to preventive health care for cancer survivors. Am J Prev Med. 2013;45(3):304–12. doi: 10.1016/j.amepre.2013.04.021.
  31. 31.
    Vieira M, Frutuoso A, Correia AM. Vacinação contra a Gripe Sazonal—Época 2012/2013. Administração Regional de Saúde do Norte; 2013. p. 1–2.Google Scholar
  32. 32.
    Meropol NJ, Schrag D, Smith TJ, Mulvey TM, Langdon Jr RM, Blum D, et al. American society of clinical oncology guidance statement: the cost of cancer care. J Clin Oncol Off J Am Soc Clin Oncol. 2009;27(23):3868–74. doi: 10.1200/JCO.2009.23.1183.CrossRefGoogle Scholar
  33. 33.
    Ward E, Halpern M, Schrag N, Cokkinides V, DeSantis C, Bandi P, et al. Association of insurance with cancer care utilization and outcomes. CA Cancer J Clin. 2008;58(1):9–31. doi: 10.3322/CA.2007.0011.CrossRefPubMedGoogle Scholar
  34. 34.
    Meropol NJ, Schulman KA. Cost of cancer care: issues and implications. J Clin Oncol Off J Am Soc Clin Oncol. 2007;25(2):180–6. doi: 10.1200/JCO.2006.09.6081.CrossRefGoogle Scholar
  35. 35.
    Mols F, Thong MS, Vissers P, Nijsten T, van de Poll-Franse LV. Socio-economic implications of cancer survivorship: results from the PROFILES registry. Eur J Cancer. 2012;48(13):2037–42. doi: 10.1016/j.ejca.2011.11.030.CrossRefPubMedGoogle Scholar
  36. 36.
    Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer. 2013;119 Suppl 11:2151–9. doi: 10.1002/cncr.28067.CrossRefPubMedGoogle Scholar
  37. 37.
    de Boer AG, Taskila T, Tamminga SJ, Frings-Dresen MH, Feuerstein M, Verbeek JH. Interventions to enhance return-to-work for cancer patients. The Cochrane database of systematic reviews. 2011(2):CD007569. doi: 10.1002/14651858.CD007569.pub2.

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Clinical Epidemiology, Predictive Medicine and Public HealthFaculty of Medicine, University of PortoPortoPortugal
  2. 2.Institute of Public Health, University of Porto (ISPUP)PortoPortugal
  3. 3.Life and Health Sciences Research Institute (ICVS), School of Health SciencesUniversity of MinhoBragaPortugal

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