Summary

Important findings

Diagnoses of thyroid, prostate and testicular cancers had little or no effect on the average five-year survival rates of Pennsylvanians. See Stage for more details.

When classifying patients by their health insurance when diagnosed, the five-year net cancer survival rates among those with Medicaid was much closer to the uninsured than those with private or Medicare insurance. See Disparities for more details.

Overall, the counties with the poorest five-year net cancer survival rates were those in the Northeast, Southwest and Philadelphia. See Geographic for more details.

There were no substantially different findings compared to last year’s analysis.

Net cancer survival by primary site

Among adult Pennsylvanians (those aged 15 or above) diagnosed with cancer during the period of 2008-2014, the five-year net cancer survival rate for all cancers combined was 64.1 percent.

With the exception of testis and thyroid cancers, diagnoses of any of the major types reduced patients’ five-year survival rate.

Figure 2: Five-year Net Survival among Pennsylvanians, Aged 15+, by Primary Site
Five-year Net Survival among Pennsylvanians, Aged 15+, by Primary Site

The primary sites with the lowest net survival rates were the pancreas (11.0), liver and intrahepatic bile duct (16.1), and esophagus (19.5). Tobacco smoking has been shown to increase the chance of developing all three of these cancer types (American Cancer Society 2015).

The five-year net survival rate for prostate cancer was 96.6 percent. This was because prostate cancer poses a very small risk of death if caught before spreading throughout the body, and most prostate cancers are diagnosed at an early stage. Other factors not accounted for in this estimate, such as affluence or insurance coverage, may have been able to raise the life expectancy of prostate cancer patients close to that of the general population.

While breast cancer is the fourth most common cause of cancer death (2,001 deaths in 2016), it has a high five-year net survival rate of 88.5 percent. In contrast, the most common cause of cancer death, cancer of the lung and bronchus (7,137 deaths), had a five-year net survival rate of 20.8 percent.

Years of life lost

Public health policy makers can use net survival rates to find disparities between populations and cancer types. Then they can use years of potential life lost (YPLL) to see where resources would have the biggest impact (Burnet, NG and Jefferies, Sarah and Benson, Richard and Hunt, DP and Treasure, Peter 2005).

YPLL is the difference between how long a person with cancer lives after diagnosis and how long the average healthy person of the same age would live. Instead of treating all deaths as equal losses, YPLL gives more weight to deaths among the young.

Here, YPLL is compared using Pennsylvanians who had been diagnosed with invasive cancer and died in 2015.

Figure 3: Years of Life Lost among Pennsylvanians Who Died in 2015
Years of Life Lost among Pennsylvanians Who Died in 2015

The cancers with high YPLL generally have similar characteristics:

  • They are more commonly diagnosed.
  • They have poor net survival.
  • A larger proportion of diagnoses are among the young.

Lung and bronchus cancer claimed 100,100 years of life in 2015, more than any other cancer type. The YPLL for this site alone accounted for 23.1 percent of the YPLL for all cancers.

Breast cancer ranked second with 49,186 YPLL. While it had relatively high net survival, it is currently the most common invasive diagnosis. Younger women, who are those diagnosed before age 65, made up 35.9 percent of the patients.

Pancreatic cancer, which had the worst net survival of the major cancer types, ranked fourth for YPLL. This is despite it being the eleventh most common diagnosis out of the 23 major cancer types.