2016-2024年美国成年癌症幸存者残疾情况的趋势

Background Cancer and its treatments often lead to physical and functional limitations, placing cancer survivors at increased risk for disability. Yet, there is a limited understanding of how the prevalence of disability has shifted in recent years. Thus, we estimated the trends in disability prevalence of cancer survivors aged ≥18 years overall and by age, sex, race and ethnicity groups. Methods We used nationally representative data from 2016-2024 Behavioral Risk Factor Surveillance System, a series of cross-sectional and telephone-based surveys of the US noninstitutionalized adults (≥18 years). Adults with self-reported cancer history (except non-melanoma skin cancer) were included. Disability was defined as having difficulty in any of the six domains: hearing, vision, cognition, mobility, self-care, and independent living. We analyzed combined disability and each disability type separately. We used a multivariable logistic regression model to estimate disability prevalence over the years, adjusting for survey year and socio-demographic and health-related factors. Subgroup analyses were performed based on age, sex, race and ethnicity. Analyses accounted for sampling weights and complex survey design. Results We included 311143 cancer survivors, representing an estimated 124.78 million survivors. Overall, 53.67% of survivors were aged ≥65 years, 57.44% were female and 35.6% had ≤high school education. The adjusted prevalence of disabilities among cancer survivors increased by 5.67% (95% CI: 4.20-7.12; P for trend<0.001), 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). All six disability domains increased ( P for trend<0.001), with mobility disability showing the most pronounced growth. In 2024, mobility issues were the most prevalent disability ( 28.73%, 95% CI: 27.77-29.69), followed by the cognition impairment (16.08%, 95% CI: 15.19-16.97), hearing disability (14.68%, 95% CI: 13.92-15.43), difficulty in independent living (13.64%, 95% CI: 12.85-14.42), vision disability (8.87%, 95% CI: 8.11-9.62) and self-care disability (7.56%, 95% CI: 6.90-8.23). The largest increase in disability occurred in 18-34-year age group (10.04%, 95% CI: 1.62-18.45), males (6.06%, 95% CI: 3.96-8.16), and other races and ethnicities (12.78%, 95% CI: 3.70-21.85). Cancer survivors with disability were more likely to be male, Non-Hispanic Black or Hispanic, less educated, unemployed, unmarried, have lower income, report poorer health, and delay medical care ( P <0.05) than those without disability. Conclusion Disability among cancer survivors increased steadily, particularly for mobility disability, yet this burden is not equally distributed across age, sex, and racial and ethnic groups. Early identification of disability and the integration of tailored care into survivorship plans are essential, especially for subgroups who experience an unequal burden.