Report Projects Cancer to Be Nation's Leading Cause of Death by 2030

An increase in the number of available anti-cancer drugs will also help lead to more people surviving the disease than ever before.

While more Americans than ever are surviving cancer, the disease is still projected to surpass heart disease as the nation’s leading cause of death by 2030, according to the American Society of Clinical Oncology (ASCO).

In its new report, State of Cancer Care in America: 2014, ASCO examines demographic, economic, and medical trends anticipated to affect cancer care in the United States in the coming decades. By 2030, the number of new cancer cases per year is projected to increase by 45%, from 1.6 million to 2.3 million, driven in large part by a rapidly aging population.

The number of new drugs available to combat cancer is projected to grow as well. The FDA approved 18 new cancer-treatment drugs and biologics in 2013, which brings the total number of currently approved anti-cancer drugs to more than 170.

“As a result of this progress, more people are surviving cancer than ever before,” the report states. “Two-thirds of Americans now live at least 5 years after a cancer diagnosis, an increase from only about half in the 1970s. Thanks to earlier detection and better treatments, the nation’s cancer death rate has decreased 20% since the early 1990s, reversing decades of increases.”

There are now 13.7 million cancer survivors living in the United States alone, and additional survivors from the projected flood of new cancer cases are expected to impose burdens of their own on the medical community. Cancer survivors face an increased risk for numerous other conditions, including diabetes, cardiovascular disease, osteoporosis, decreased functional status, and other types of cancer, the ASCO report notes.

A total of approximately 18 million people are expected to survive cancer by 2022, which represents an increase of more than 35% from today.

“These patients require services offered by multiple health care providers in addition to oncologists to adequately address their unique health concerns,” the report authors write. “One study estimated that the annual excess economic burden of survivorship among recently diagnosed cancer survivors … is more than $16,000 per survivor and, among those previously diagnosed … more than $4,000 per year. The growing number of long-term survivors of cancer is a success story, but now requires greater focus on transitions in care and coordination with other providers.”

The total annual cost of treating cancer is expected to rise from $104 billion in 2006 to at least $173 billion by 2020.

Of particular concern to ASCO is that along with the growing number of cancer cases, there are projected to be fewer oncologists available to treat them. In addition, the Congressional Budget Office projects that an additional 29 million people will obtain health insurance through the Affordable Care Act (ACA) by 2017, creating even greater demand for the services of oncologists.

The number of oncologists to treat this new demand, however, is not expected to grow sufficiently to meet the challenge. The portion of oncologists aged 64 and older surpassed the portion of oncologists younger than 40 for the first time in 2008, and the gap has widened since then, according to the ASCO report.

ASCO projects a significant impact on cancer care in the future will come from the large number of medical oncologists 64 years of age and older who will be transitioning out of the workforce. The report raises concerns due to the size of the cohort who may retire soon, in addition to a heavier clinical workload these physicians carry compared to those 45 years of age and under, based on self-reported patient visits per week.

ASCO projects that by 2025, the overall demand for medical oncology services will grow by 42%, with 15,721 hematologists and oncologists needed to provide full-time equivalent (FTE) clinical care. However, the supply of hematologists and oncologists is only projected to grow 28%, leading to a shortage of 1487 clinical care positions.

“These figures do not take into account the increase in demand that is likely to occur as a result of the impact of the ACA on insurance coverage,” the authors write. “When fully implemented, the ACA could increase the demand by an additional 130 clinical care FTE hematologists/oncologists per year by 2025.”