Health status of middle-aged and older cancer survivors: a nationwide cross-sectional study from the China Health and Retirement Longitudinal Study (CHARLS)

BACKGROUND: The number of Chinese cancer survivors has increased bolstered by the combined trends of an aging population and improved cancer survival; however, related research on cancer survivorship remains limited. Therefore, this study aimed to provide an overview of the health status of middle-aged and older cancer survivors in China. METHODS: We used the cross-sectional self-reported survey data from wave 4 in the China Health and Retirement Longitudinal Study (CHARLS). A total of 354 cancer survivors and 16,664 participants without cancer were identified from CHARLS. Physical and mental health, health behavior, and health care information collected by questionnaire were compared between these two groups. RESULTS: Compared with the general middle-aged and older population, cancer survivors had more concomitant chronic diseases (2.75 vs. 2.00, P<0.001). In addition, cancer survivors were found to be more statistically likely to have difficulties with activity (3.53 vs. 2.39, P<0.001) and have depressive symptoms (10.07 vs. 8.01, P<0.001) compared with participants without cancer. Also, cancer survivors were less likely to drink compared to those without a cancer diagnosis (OR 0.49; 95% CI, 0.36–0.66, P<0.001), but smoking behavior and physical activity did not show a significant difference. Coexisting chronic diseases and smoking harmed the physical and mental health of middle-aged and older people. We also found that cancer survivors had higher medical care expenses when compared with participants without cancer. CONCLUSIONS: Cancer survivors older than 45 years in China have poorer outcomes in comorbidities and physical and mental health than their age-matched individual counterparts without cancer. Therefore, a higher quality and more cost-effective supportive care for these individuals is needed.