More than 25% of cancer survivors report significant levels of disability after cancer diagnosis, according to new study

• Findings underscore need for disability-prevention efforts among survivors and patients undergoing cancer treatment
• Functional disabilities also found to be more prevalent in survivors from racial/ethnic minorities and underserved groups

A survey of nearly 50,000 cancer survivors has found that more than a quarter had a physical disability that impaired their mobility and almost 10% had a disability affecting self-care, Dana-Farber Cancer Institute researchers report in a new study, published in the Journal of Clinical Oncology today. Both rates are sharply higher than those for adults who have not had cancer.

If the findings are extended to the estimated 18.1 million cancer survivors in the U.S., they suggest that more than 5 million survivors have a mobility disability and 1.3 million have a self-care disability, according to the study authors. The impact of such disabilities falls especially heavily on members of racial and ethnic minorities, underserved groups, and individuals with unhealthy lifestyles or other medical conditions.

The study findings underscore the importance of developing ways to limit the long-term side effects of cancer treatment, and of the benefits of exercise, both during and after treatment, to preserve physical function and ward off disability, researchers say.

"The effects of cancer and its treatment can lead to a variety of physical limitations that impair people's quality of life and ability to care for themselves," says Chao Cao, PhD, MPH, first author of the study. "Even as the number of cancer survivors has grown, the prevalence and patterns of physical disabilities in this group have received little scientific attention. Our study is one of the first to examine this issue."

Data for the study came from the Behavioral Risk Factor Surveillance System, a nationwide, telephone-based survey by the U.S. Centers for Disease Control and Prevention that collected data on health-related risk behaviors and chronic medical conditions among U.S. adults. Researchers focused on data from 47,768 cancer survivors and 2.4 million adults without a history of cancer who participated in the survey.

After adjusting for demographic and lifestyle factors and health conditions, the researchers found that 27.9% of cancer survivors had a mobility disability – difficulty walking or climbing stairs, for example – compared to 13.4% among non-cancer adults. And 7.4% of survivors had a disability in self-care activities such as dressing or bathing, compared to 3.8% of non-cancer adults.

Investigators also found different rates of disability within different groups of survivors. Female survivors, for example, were significantly more likely to report mobility problems than male survivors were. Mobility-related disabilities were also more common in non-Hispanic Blacks, Native Americans, and Hispanics than in non-Hispanic whites.

Low educational attainment, low family annual income, being unmarried, having obesity, current smoking, being physically inactive, and having a chronic condition, were also associated with a higher prevalence of mobility disability among cancer survivors.

"These results point to the need for prevention efforts targeted at groups more likely to experience cancer-related disability," says study senior author, Jennifer Ligibel, MD, of Dana-Farber.

Funding for the study was provided by a grant from the National Cancer Institute.