Life expectancy is increasing worldwide. At the same time, the risk of cancer increases with age. However, exact figures have hardly been available so far. A Finnish study recently reported rising incidences especially in the "oldest of the old" with an age above 85 years - this also has implications for the care of these patients.
The study reported on the cancer burden of the "oldest of the old" (≥ 85 years) in Finland between 1953-2017 and estimated the age-specific cancer incidence in the elderly population between 65 and 99 years. The Finnish Cancer Registry provided data on cancer diagnoses, cancer-related mortality and general mortality. According to the data, between 1953 and 2017, the proportion of cancer cases in the age group of ≥ 85 years increased significantly.
For example, the incidence of cancer among people aged ≥ 85 years increased from 1.5% to 9.6% (from 597 to 15,360 new cases) between 1953 and 2017. In the period 2013 to 2017, more new cancer cases were also diagnosed in the age group ≥ 85 years than in the age group below 50 years.
For patients aged between 85 and 94 years, cancer incidence and excess mortality reached their respective maximum. Above this age, however, cancer-specific mortality continued to increase or reached a plateau.
Due to current demographic changes, the number of new cancer cases has increased especially among the oldest people in Finland and also in other countries around the world. For example, Finnish data showed that almost one in ten newly diagnosed cancers now occurs in the age group between 85 and 94 years.
The increasing cancer burden in the very elderly equally poses a growing challenge for the healthcare of these patients. On the one hand, this affects cancer research, which has mostly paid too little attention to very old patients. On the other hand, however, it also affects reporting in the cancer registries, among others, which have to take competing mortality risks into account, especially in the very old.
An important practical aspect of everyday hospital life must also not be forgotten here: Very old patients are mostly multimorbid and thus have a poorer ECOG status. Individual therapeutic measures in the field of oncology are therefore more often inaccessible to very old patients. How to deal with this situation and an increasing incidence of cancer in these age groups in the future should therefore be considered more intensively today.
Reference:
Tanskanen T et al., Cancer Incidence and Mortality in the Oldest Old: A Nationwide Study in Finland. Am J Epidemiol 2021; 190(5): 836–842