The Challenge

Populations around the world are rapidly ageing. According to the World Health Organisation (WHO), the number of people over 60 years is set to double by 2050. As a consequence, this will lead to increased demand for primary health care and long-term care as well as larger and better trained workforce that can respond better to the health needs of the elderly population. Universal health coverage and the health goal of the 2030 Agenda for Sustainable Development provide the foundations to adequately address the emerging societal challenges related to cancer amongst the ageing populations.

As oncologists around the world shift their focus to the field of geriatrics, increased understanding of the impact of research, innovation and clinical practices for older adults with cancer is becoming of critical importance. Since the early 2000s, the International Society of Geriatric Oncology (SIOG) has positioned itself as an influential stakeholder of the strengthening of health workforce for improving the care of older patients with cancer around the world.

Why Geriatric Oncology

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The world population is ageing thanks to global improvement in health care and living conditions. It has been estimated that by 2020, the population of the elderly worldwide would be more than 700 million with two-third in the developing countries [1] [2].
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Advancing age is a high risk factor for cancer, with individuals over 65 accounting for 60% of newly diagnosed malignancies and 70% of all cancer deaths, mainly prostate, bladder, colon, uterus, pancreas, stomach, rectum, and lung carcinomas [1] [3] [4].
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new cases were diagnosed in 2012 and this number could rise up to 22 within the next 2 decades [5].
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In developed countries, half of the cancers already occur in patients aged 70 and older [5].
[1] Sarkar, A. and Shahi, U.P. (2013) Assessment of Cancer Care in Indian Elderly Cancer Patients: A Single Center Study. South Asian Journal of Cancer, 2, 202-208. http://dx.doi.org/10.4103/2278-330X.119904
[2] Steer, C.B., Marx, G.M. and Singhal, N. (2009) Cancer in Older People: A Tale of Two Disciplines. Internal Medicine Journal, 39, 771-775. http://dx.doi.org/10.1111/j.1445-5994.2009.02056.x
[3] Berger, N.A., Savvides, P. and Koroukian, S.M. (2006) Cancer in the Elderly. Transactions of the American Clinical and Climatological Association, 117, 147-156.
[4] Monfardini, S. (2004) Elderly Oncology: A New Subspecialty? Journal of Clinical Oncology, 22, 4655. http://dx.doi.org/10.1200/JCO.2004.04.186
[5] World Cancer Report 2014

Why Focus on Older Patients

Majority of cancer diagnoses occur in people aged over 65 

  • Age related changes to tumour biology

  • Lack of research on effective treatments for older people

  • Increased vulnerability to the side effects of treatments

  • Inadequate screening and assessment instruments as validated tools in clinical practice

Global Perspectives : Why Geriatric Oncology

What is Geriatric Oncology About

  • How should oncologists be individualising their treatment approach based on the risks and benefits of therapy?

  • What instruments can help oncologists to have a better view of the patient’s overall health situation?

  • How does the cancer and the cancer treatment impact the aging process of the patient?

Cancer Burden in Older Populations

ADDITIONAL RESOURCES

  1. 2020 July – ASCO Post article “Geriatric Assessment: What Are You Waiting For?” by Stuart M. Lichtman
  2. In Memoriam of Dr. Rosemary Yancik. L Balducci, S Monfardini, L Ferrucci. J Geriatr Oncol. 2020 Jun 2;S1879-4068(20)30276-9. doi: 10.1016/j.jgo.2020.05.007.
  3. Geriatric Oncology: A Multidisciplinary Approach in a Global Environment by Gouri Shankar Bhattacharyya, MD, and Stuart M. Lichtman, MD. The ASCO Post, June 10, 2017.
  4. WHA Cancer Resolution 2017: Member States should increase efforts to strengthen health systems at the national and local levels to ensure early diagnosis and accessible, affordable and high quality care for all cancer patients
  5. Over the coming decades Asia will rapidly age, governments must prepare for this reality: Asian Development Bank https://www.adb.org/features/asia-s-growing-elderly-population-adb-s-take
  6. World Cancer Report 2014, WHO
  7. United Nations Population Fund – Ageing https://www.unfpa.org/ageing
  8. Decade of Healthy Ageing
  9. Global network on Age friendly cities and communities
  10. Editorial: The older patient; the need for Geriatric Units by J. Gorjao Clara, European Geriatric Medicine 2015.