Age-Specific Cancer Incidence Rates Increase Through the Oldest Age Groups

doi:10.1097/MAJ.0000000000000281

The American Journal of the Medical Sciences

Volume 348, Issue 1, July 2014, Pages 65-70

https://doi.org/10.1097/MAJ.0000000000000281 Get rights and content

Abstract

Background

In the United States, from 2005 to 2009, nearly 8% of all cancers diagnosed and 15% of cancer deaths occurred in individuals aged 85 years and older (85 + age group). With the aging of the U.S. population, an analysis of incidence of cancer in the elderly population may provide information for clinical care and resource allocation.

Materials and Methods

Previously reported data were retrieved from the Surveillance Epidemiology and End Results (SEER) 18 Registry for years 2000 to 2010 and Central Brain Tumor Registry of the United States (CBTRUS) for years 2004 to 2008. Cancers included invasive cases only, except for nonmalignant meningiomas, and rates were per 100,000.

Results

The age-specific cancer incidence rate (IR) increases with age until a decrease in the 85 + age group. IR for all cancers combined for this age group was 2,317 per 100,000. Statistically, males had significantly higher IR compared with females (3,194 versus 1,911 [P ≤ 0.0001]). Blacks had an IR similar to whites (2,255 versus 2,340 [P = 0.12]). Despite a drop in the overall IR in this oldest age group, IR for certain cancers continued to increase. Among these cancers, gastrointestinal cancers like colorectal, pancreatic and stomach had the highest incidence and mortality rates.

Conclusions

This study contributes to measuring cancer burden in the oldest old population. In certain cancers, including meningiomas, the IR continues to rise with advancing age. Management of cancer in elderly is challenging and screening persons in the 85 + age group for frailty very thoroughly may help guide decisions of palliative versus aggressive therapies.

Section snippets

MATERIALS AND METHODS

overall age-specific and site-specific cancer incidence and mortality rates were obtained to determine age-related patterns. Incidence and mortality rates were obtained online from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) website.⁴ Specifically, data were extracted from the SEER 18 Registry and included invasive cancer cases newly diagnosed in the years 2000 to 2010. Age-specific rates for malignant and nonmalignant meningiomas were obtained from the

RESULTS

Cancer IRs increase with advancing age and peak at 80 to 84 years (2500 per 100,000) before beginning to decline in the 85 + age group (2340 per 100,000) (Figure 1).⁴ Despite this, certain cancers continue to increase in incidence even after age 85 years (Table 1), which brings to attention the need to continue screening for these cancers in the elderly population and also emphasizes the role of age in the etiology of these cancers.

DISCUSSION

We obtained data from the SEER research cancer registry, which encompasses about 28% of the U.S. population, and included all those cancer sites available in the SEER registry with the exception of meningioma. Mortality rates may have been affected by other variables not included in the SEER registry, such as comorbid conditions, treatment efficacy and tolerance as well as biologic differences⁸ in the oldest age group.

Overall age-specific IR in the oldest age group declines. This could be

CONCLUSIONS

Our study contributes to measuring cancer burden in the oldest old population with use of SEER and CBTRUS data. We demonstrate that incidence of certain cancers continues to climb through the oldest old population, despite an overall drop in cancer IR in this age group. Gastrointestinal cancers like colorectal, pancreas and stomach had the highest incidence and mortality rates among these cancers.

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JPT and JLV were supported by the National Cancer Institute (R03CA156561). The authors have no financial or other conflicts of interest to disclose.

Presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, June 1–5, 2012, Chicago, IL.

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Clinical InvestigationAge-Specific Cancer Incidence Rates Increase Through the Oldest Age Groups

Abstract

Background

Materials and Methods

Results

Conclusions

Section snippets

MATERIALS AND METHODS

RESULTS

DISCUSSION

CONCLUSIONS

Exp Gerontol

Crit Rev Oncol Hematol

Clin Oncol (R Coll Radiol)

The older population: 2010 (2010 census briefs)

SEER cancer statistics review, 1975–2009 (vintage 2009 populations). Based on November 2011 SEER data submission, posted to the SEER web site, April 2012

Deaths: preliminary data for 2010. National Vital Statistics reports (table 6: expectation of life at selected ages by race, Hispanic origin, race for non-population, and sex: United States, preliminary 2010), in National Vital Statistics Reports

Statistical Report: primary brain and central nervous system tumors diagnosed in the United States in 2004–2008, in Central Brain Tumor Registry of United States (CBTRUS)

Factors associated with survival in patients with meningioma

J Neurosurg

Cancer in the elderly

Trans Am Clin Climatol Assoc

Peak and decline in cancer incidence, mortality, and prevalence at old ages

Cancer

Clinical Investigation
Age-Specific Cancer Incidence Rates Increase Through the Oldest Age Groups