Dataset Information

The State of Cancer Rehabilitation in the United States.

ABSTRACT: The field of cancer rehabilitation and prehabilitation has grown significantly over the past decade. Advancements in early detection and treatment have resulted in a growing number of cancer survivors in the United States (US), expected to reach 26 million by 2040.1 Health care professional graduate education is trying to catch up with anticipated clinical demand by increasing the number of cancer rehabilitation fellowship training programs and introducing rehabilitation/prehabilitation concepts earlier in training. Numerous national organizations have issued guidelines for cancer rehabilitation research and posttreatment cancer health care. As treatment modalities evolve, so too must research on side-effects and multisystem management over the continuum of care. Current research strategies address different cancer types with a broad focus on timing of interventions, cost effectiveness, efficacy of rehabilitation, and improving screening and assessment tools. A collaborative, interdisciplinary research model is paramount to deepen impact and broaden reach. Policy supports could advance cancer survivorship and rehabilitative care. Funding to advance evidence-based practices for distress screening, psychosocial support, survivorship care planning, and rehabilitation services remains critical. Current social policies and health care access protections must be expanded to best serve the growing number of cancer survivors in the US. Equitable health care access, health care experience and health care outcomes remain a critical area for research and policy supports. The cost of cancer treatment requires significant reform to ensure access to all. Rehabilitation services are elements of standards of care for many neurological, cardiovascular and orthopedic diagnoses, but currently are not standard for actual or potential dysfunctions among cancer survivors. Both the disease process and the variety of therapeutic modalities increase risks of dysfunction, impairments, poor survival, and diminished quality of life. Rehabilitation focuses on optimizing quality of life and maximizing function throughout the continuum of cancer care. Health care professionals are urged to integrate high quality interdisciplinary care to promote collaboration and dissemination of knowledge which will yield better care for cancer survivors. Prehabilitation has the potential to play key roles in reducing or eliminating many cancer-related impairments and disabilities.

SUBMITTER: Silver JK

PROVIDER: S-EPMC6415687 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The State of Cancer Rehabilitation in the United States.

Silver Julie K JK Stout Nicole L NL Fu Jack B JB Pratt-Chapman Mandi M Haylock Pamela J PJ Sharma Raman R

Journal of cancer rehabilitation 20181230

The field of cancer rehabilitation and prehabilitation has grown significantly over the past decade. Advancements in early detection and treatment have resulted in a growing number of cancer survivors in the United States (US), expected to reach 26 million by 2040.<sup>1</sup> Health care professional graduate education is trying to catch up with anticipated clinical demand by increasing the number of cancer rehabilitation fellowship training programs and introducing rehabilitation/prehabilitati ...[more]

PMID: 30882090

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Project description:ImportanceInformation on the economic burden of cancer mortality can serve as a tool in setting policies and prioritizing resources for cancer prevention and control. However, contemporary data are lacking for the United States nationally and by state.ObjectiveTo estimate lost earnings due to death from cancer overall and for the major cancers in the United States nationally and by state.Design, setting, and participantsPerson-years of life lost (PYLL) were calculated using numbers of cancer deaths and life expectancy data in individuals aged 16 to 84 years who died from cancer in the United States in 2015. The annual median earnings in the United States were used to assign a monetary value for each PYLL by age and sex. Cancer mortality and life expectancy data were obtained from the National Center for Health Statistics and annual median earnings from the US Census Bureau's 2016 Current Population Survey's March Annual Social and Economic Supplement. Data analysis was performed from October 22, 2018, to February 25, 2019.Main outcomes and measuresLost earnings due to cancer death, represented as estimated future wages in the absence of premature death.ResultsA total of 8 739 939 person-years of life were lost to cancer death in persons aged 16 to 84 years in the United States in 2015, translating to lost earnings of $94.4 billion (95% CI, $91.7 billion-$97.3 billion). For individual cancer sites, lost earnings were highest for lung cancer ($21.3 billion), followed by colorectal ($9.4 billion), female breast ($6.2 billion), and pancreatic ($6.1 billion) cancer. Age-standardized lost earning rates per 100 000 were lowest in the West and highest in the South, ranging from $19.6 million (95% CI, $19.1 million-$20.2 million) in Utah to $35.3 million ($34.4 million-$36.3 million) in Kentucky. Approximately 2.4 million PYLL and $27.7 billion (95% CI, $26.9 billion-$28.5 billion) in lost earnings (29.3% of total that occurred in 2015) would have been avoided in 2015 if all states had the same age-specific PYLL or lost earning rates as Utah.Conclusions and relevanceOur findings indicate large state variation in the economic burden of cancer and suggest the potential for substantial financial benefit through delivery of effective cancer prevention, screening, and treatment to minimize premature cancer mortality in all states.

Project description:Building collisions are a leading threat to wild birds; however, only those that are found dead or fatally wounded are included in current mortality estimates, with injured or stunned birds largely assumed to survive long-term. Avian building collision victims are often brought to wildlife rehabilitators for care, with the hopes they can be released and resume their natural lives. We examined the wildlife rehabilitation records of over 3,100 building collisions with 152 different avian species collected across multiple seasons to identify patterns of survival and release among patients. The number of admissions varied by season; fall migration had the highest number of cases and winter had the least number of cases, and summer having the lowest release proportion and winter having the highest. The most common reported injury was head trauma and concussion. Our logistic and Poisson models found that mass had a strong positive effect on release probability, and the season of summer had a strong negative effect on release probability. Mass and winter had a strong positive effect on treatment time, and age and the seasons of fall and winter had a strong negative effect on treatment time in these models. Ultimately, about 60% of patients died in care, either by succumbing to their injuries or by euthanasia. Patients that were released remained in care for longer than patients that died. This study reports different data than carcass studies and views bird-building collisions from the perspective of surviving victims to explore longer-term effects of these collisions on mortality. Increased communication and collaboration between wildlife rehabilitators and conservation researchers is recommended to better understand building collisions and how to respond to this leading threat to wild birds. These findings, along with our estimate of delayed mortality, suggest that overall collision mortality estimates based on carcass collection far exceed one billion birds in the U.S. each year.

Dataset Information

The State of Cancer Rehabilitation in the United States.

Publications

The State of Cancer Rehabilitation in the United States.

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