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  • Cited by 2
  • Print publication year: 2009
  • Online publication date: May 2010

36 - Cancer in the Elderly

Summary

INTRODUCTION

Cancer is a major public health problem with a disproportionate impact on older adults. The lifetime risk of developing cancer is 1 in 2 for men and 1 in 3 for women. Seventy-six percent of all cancers occur in patients older than the age of 55. From 2000 to 2003 the median age of cancer at time of diagnosis was 67 years. During this time, the median age at death was 73 years old. There are epidemiological differences based on ethnicity, with African-Americans having both the highest cancer incidence and mortality. Factors accounting for differences are multifactorial and a topic of ongoing research. The overall health care costs associated with cancer were estimated to have been $219.2 billion in 2007. As the size of the elderly population continues to increase, all health care professionals can expect to care for a steadily increasing number of older patients with cancer.

Cancer and Aging

Although principally a geriatric disease, under no circumstances should cancer be considered a normal consequence of aging. The relationship between cancer biology and the biology of aging is multidimensional and has yet to be fully understood. The incidence of some cancers such as breast, prostate, and colon increases with advancing age, whereas others such as cervical cancer are less frequent. The increasing prevalence of cancer with advancing age is thought to result from the accumulation of damaging genetic events and mutations that occur over time, the decline of DNA repair mechanisms over time, and the decline in cellular immunity. Additionally, the aggressiveness of cancer with advancing age can vary.