Survival improvements in major cancers: Trends and disparities in the United States, 2000–2019

Advances in cancer management have improved oncologic outcomes, but the extent of these improvements and disparities across demographic and socioeconomic groups over the past two decades remains unclear. We identified patients diagnosed with primary cancer at eight sites (lung and bronchus, liver and intrahepatic bile ducts [IHBD], esophagus, colon, kidney, pancreas, rectum, and stomach) between 2000 and 2019 from the Surveillance, Epidemiology, and End Results (SEER)-17 database. Kaplan-Meier curves were used to evaluate cancer-specific survival (CSS) across different diagnostic periods, and Cox proportional hazards models were employed to adjust for confounding factors. We found that CSS for eight cancers improved significantly between 2000 and 2019, but the extent of improvement varied by population characteristics. Elderly patients, unmarried individuals, those with low income, and rural residents showed poorer relative CSS improvement across all eight cancers. Relative CSS improvement differences by sex were present across the eight cancers but remained small. Black patients exhibited less relative CSS improvement than White patients only in pancreatic cancer. Absolute 5-year CSS differences by race (White vs. Black) decreased in six cancers except pancreatic and gastric cancers. In summary, the extent of improvement in CSS for the eight cancers varied by demographic characteristics between 2000 and 2019. Absolute survival differences by age, marital status, income, and place of residence widened for most cancers, while racial differences (White vs. Black) narrowed for most cancers. This provides potential recommendations for further adjustments in medical resources.