Trends and Disparities in Disability Among US Adult Cancer Survivors, 2016-2024

BACKGROUND: Cancer and its treatments often lead to physical and functional limitations, placing cancer survivors at increased risk for disability. Yet, recent changes in disability prevalence remain unclear. We estimated trends in the prevalence of disability from 2016 to 2024 among cancer survivors. METHODS: We used nationally representative data from the 2016-2024 Behavioral Risk Factor Surveillance System, a series of cross-sectional and telephone-based surveys of noninstitutionalized adults, ≥18 years, in the US. Adults with self-reported cancer history (except non-melanoma skin cancer) were included. Disability was defined as having difficulty in any of the following six domains: hearing, vision, cognition, mobility, self-care, and independent living. Survey-weighted multivariable logistic regression models were used to estimate disability prevalence overall and by age, sex, races and ethnicities. RESULTS: We included 311,143 cancer survivors (weighted for 124.78 million). The adjusted prevalence of disability increased by 5.67% (95% CI: 4.20-7.12), from 40.12% in 2016 to 45.78% in 2024. The steepest increase occurred between 2020 and 2021 (by 4.04%, 95% CI: 2.28-5.80). Mobility disability demonstrated the highest prevalence (28.73% in 2024) among six domains. The 18-34-year age group, males, other races and ethnicities showed a more pronounced increase compared with their respective counterparts. CONCLUSIONS: Disability among cancer survivors increased steadily, particularly for mobility disability. This burden is not equally distributed across age, sex, and racial and ethnic groups. IMPACT: The study findings suggest the urgent need for integrating proactive surveillance and targeted rehabilitative interventions into routine oncology care, aiming to mitigate the disability burden in cancer survivors.