Journal of Cancer Survivorship

, Volume 10, Issue 5, pp 850–864 | Cite as

Complementary and alternative medicine use among US cancer survivors

  • Gabriella M. John
  • Dawn L. Hershman
  • Laura Falci
  • Zaixing Shi
  • Wei-Yann Tsai
  • Heather GreenleeEmail author



US cancer survivors commonly use vitamins/minerals and complementary and alternative medicine (CAM). We compare use of vitamins/minerals and CAM between adult cancer survivors and cancer-free adults and estimate annual out-of-pocket expenses.


Data on self-reported vitamin/mineral and CAM use in the past 12 months from the cross-sectional 2012 US National Health Interview Survey were used to estimate prevalence of use and out-of-pocket expenditures. The cohort included adults with (n = 2977) and without (n = 30,551) a self-reported cancer diagnosis.


Approximately 79 % of cancer survivors and 68 % of cancer-free adults reported using ≥1 vitamins/minerals and/or CAM modality in the past year. Compared to cancer-free adults, cancer survivors were more likely to report use of vitamin/minerals (75 vs. 61 %, P < 0.001), non-vitamin/mineral natural products (24 vs. 19 %, P < 0.001), manipulative and body-based therapies (19 vs. 17 %, P = 0.03), and alternative medical systems (5 vs. 4 %, P = 0.04). Adult cancer survivors and cancer-free adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket, respectively, on vitamins/minerals and CAM. Survivors spent 60 % of the total on vitamins/minerals ($4 billion), 18 % ($1.2 billion) on non-vitamin/mineral natural products, and 7 % ($0.5 billion) on massage.


Compared with cancer-free adults, a higher proportion of cancer survivors report vitamin/mineral and CAM use. Cancer survivors, who accounted for 6.9 % of the total population, accrued more than 11.4 % of the annual out-of-pocket costs on vitamins/minerals and CAM spent by US adults.

Implications for Cancer Survivors

Given the high use of vitamins/minerals and CAM in cancer survivors, studies are needed to analyze health outcomes and the cost/benefit ratio of such use.


Vitamins Complementary therapies Complementary medicine Healthcare costs Cancer 



The authors thank Richard Nahin, Ph.D. at the National Center for Complementary and Integrative Health for his insightful comments and helpful suggestions on the data analysis and interpretation. Funding was provided by National Cancer Institute K23CA141052 (to Heather Greenlee).

Compliance with ethical standards

Conflict of interest



An earlier version of this analysis was presented at the 2014 International Research Congress on Integrative Medicine and Health in Miami, Florida.

Supplementary material

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Gabriella M. John
    • 1
  • Dawn L. Hershman
    • 1
    • 2
    • 3
  • Laura Falci
    • 1
  • Zaixing Shi
    • 1
  • Wei-Yann Tsai
    • 4
    • 3
  • Heather Greenlee
    • 1
    • 3
    Email author
  1. 1.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  2. 2.Department of Medicine, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  3. 3.Herbert Irving Comprehensive Cancer CenterColumbia University Medical CenterNew YorkUSA
  4. 4.Department of Biostatistics, Mailman School of Public HealthColumbia UniversityNew YorkUSA

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