TY - JOUR
T1 - Cancer in the oldest old in the United States
T2 - Current statistics and projections
AU - Gundrum, Jacob D.
AU - Go, Ronald S.
N1 - Funding Information:
Research progress in geriatric oncology has remained stagnant until recently. Particularly concerning is the underrepresentation of older patients in clinical trials. The median ages at diagnosis for breast, prostate, colorectal, and lung cancers in the U.S. were 61, 67, 70, and 71 years, respectively, in 2004–2008, 22 but only about a third (32%) of patients enrolled into NCI cooperative group trials in recent years were 65 years and older. 23 In a study conducted by the Food and Drug Administration (FDA), only 9% of patients enrolled into 55 cancer drug registration trials in the U.S. were age 75 years and over, even though 31% of cancer patients in the U.S. are within this age range. 24 This is despite the fact that only 7% of adult oncology clinical trials set an upper age limit for enrollment eligibility. 25 In order to identify gaps and opportunities in geriatric oncology research, the National Institute on Aging and the NCI recently funded a U13 grant to develop a series of conferences, “Geriatric Oncology Research to Improve Clinical Care”. 26
PY - 2012/10
Y1 - 2012/10
N2 - Objectives: The oldest old population in the US, defined as aged ≥ 85. years, is projected to double from 4.3. million in 2000 to 9.6. million in 2030. The purpose of this study was to assess the current and projected cancer burden in the oldest old. Materials and Methods: This was a retrospective cohort study using the national Surveillance, Epidemiology, and End Results (SEER) tumor registry. Historical trends were assessed and projections were created for the top 10 cancers by incidence, and also by proportion of cancer deaths for those aged ≥ 85. years. Results: Currently, the oldest old experiences about 7% of annual new cancer cases and 14% of cancer deaths. The most common cancers by incidence per 100,000 people are colorectal (336), lung (297), breast (254), and prostate (165), while the leading causes of cancer deaths are lung (19%), colorectal (13%), prostate (9%), and breast (7%). The incidences of non-Hodgkin lymphoma, melanoma, bladder, lung, and pancreatic cancers have been increasing, while those of other cancers are stable or decreasing. A substantial proportion of the oldest old (24%) had prior primary cancers. If historical trends continue to 2030, we project that 9% of newly diagnosed cancer cases and 23% of cancer deaths annually will occur in the oldest old. Conclusion: The oldest old may have unique cancer incidence and mortality. To manage a projected major increase in the burden of cancer care, substantial investments in geriatric oncology research, education, and practice are needed.
AB - Objectives: The oldest old population in the US, defined as aged ≥ 85. years, is projected to double from 4.3. million in 2000 to 9.6. million in 2030. The purpose of this study was to assess the current and projected cancer burden in the oldest old. Materials and Methods: This was a retrospective cohort study using the national Surveillance, Epidemiology, and End Results (SEER) tumor registry. Historical trends were assessed and projections were created for the top 10 cancers by incidence, and also by proportion of cancer deaths for those aged ≥ 85. years. Results: Currently, the oldest old experiences about 7% of annual new cancer cases and 14% of cancer deaths. The most common cancers by incidence per 100,000 people are colorectal (336), lung (297), breast (254), and prostate (165), while the leading causes of cancer deaths are lung (19%), colorectal (13%), prostate (9%), and breast (7%). The incidences of non-Hodgkin lymphoma, melanoma, bladder, lung, and pancreatic cancers have been increasing, while those of other cancers are stable or decreasing. A substantial proportion of the oldest old (24%) had prior primary cancers. If historical trends continue to 2030, we project that 9% of newly diagnosed cancer cases and 23% of cancer deaths annually will occur in the oldest old. Conclusion: The oldest old may have unique cancer incidence and mortality. To manage a projected major increase in the burden of cancer care, substantial investments in geriatric oncology research, education, and practice are needed.
KW - Age distribution
KW - Aged 85 and over
KW - Cancer epidemiology
KW - Health services for the aged
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U2 - 10.1016/j.jgo.2012.08.003
DO - 10.1016/j.jgo.2012.08.003
M3 - Article
AN - SCOPUS:84866406300
SN - 1879-4068
VL - 3
SP - 299
EP - 306
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 4
ER -