Meeting the Challenges of Cancer in the Elderly — ASN Events

Meeting the Challenges of Cancer in the Elderly (#1)

David Roder 1
  1. Professor, Cancer Epidemiology and Population Health, Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia

Cancer incidence rates increase as people get older [by about 2-fold as people age from their early 60s to late 70s and older]. This scale of increase applies in Australia and globally. The corresponding increase in cancer death rates as people get older is about 3-4 fold.

Population increases of around 25% are projected to occur over the next 30 years, with larger increases of more than two-fold occurring in the age range of 75 years and over. The effect of these demographic changes will be to increase:
• Overall numbers of cancers by about 60% in Australia and by about 80% globally.
• Overall numbers of cancer deaths by around 80% in Australia and 90% globally.

The proportion of cancers diagnosed in people aged 75 years or more will increase from around 30% now to 40% in Australia over the next 30 years and from around 20% now to 30% globally. Meanwhile the proportions of cancer deaths occurring in people aged 75 years or more will increase from about 47% now to 58% in Australia and from around 30% now to 38% globally.

As a consequence of these changes:
• Service capacity will need to increase substantially.
• Service providers will need to manage more terminal cases as a proportion of their active patient case loads and a greater proportion of their cases with multiple co-morbidities.
• Increasingly clinical protocols based on trial evidence from younger healthier patients will not be relevant and will need to be variable to best meet the variable needs of a more heterogeneous, frail and elderly patient population
• New information systems and evidence based approaches will be needed to guide changes in clinical practice.
• The mix of cancers and causes of cancer death will change and service planning will need to provide for this.

  1. This presentation describes expected challenges in meeting cancer needs over the next 30 years. Reference is made to the data systems that will be required if these challenges are to be met effectively.