腫瘤發生比率在85歲以前一般隨年齡增長而增長，85歲以後腫瘤總的發病率降低，但有些腫瘤尤其消化道腫瘤仍然增加

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PMC full text:
Am J Med Sci. Author manuscript; available in PMC 2015 Jul 1.
Published in final edited form as:
Am J Med Sci. 2014 Jul; 348(1): 65–70.
doi:  10.1097/MAJ.0000000000000281

 

腫瘤發生比率在85歲以前一般隨年齡增長而增長，85歲以後腫瘤總的發病率降低，但有些腫瘤尤其消化道腫瘤仍然增加

Abstract

Introduction

In the U.S., 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 2000–2010 and Central Brain Tumor Registry of the United States (CBTRUS) for years 2004–2008. Cancers included invasive cases only, except for non-malignant 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 as compared to 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 (GI) cancers like colorectal, pancreatic, and stomach had the highest incidence and mortality rates.

Conclusions

Our study contributes to measuring cancer burden in the oldest old population. Certain cancers including meningiomas the IR continue 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.

Keywords: Cancer, age 85+, incidence, mortality, epidemiology

 

Figure 1

 
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Age-specific (Crude) SEER US incidence rates of all cancer sites combined, all ages, all races, both sexes 2000–2010. X-axis: Age group; Y-axis: IR per 100,000. Cancer sites include invasive cases only. Incidence source: SEER 18 areas [4].

 
 
  

Table 1

Incidence rates (IR) for all age groups, of certain cancer sites that continue to increase in IR in the 85+ age group.

Cancer Sites Age Groups
<1 1–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44
Colorectal * * * 0.05 0.3 0.9 2 4.3 8.2 15.8
Pancreas * * * * 0.06 0.09 0.2 0.4 1 2.5
Stomach * * * * 0.06 0.2 0.5 1.02 1.8 2.9
Myelodysplastic syndromes 0.2 0.1 0.08 0.07 0.1 0.1 0.1 0.2 0.3 0.6
Lymphocytic leukemia 2.1 7.8 3.4 2.1 1.7 1 0.7 0.9 1.1 1.7
Vulva * * * * * 0.2 0.2 0.5 1 1.6
Soft tissue including heart 3.5 1.2 0.6 0.9 1.1 1.3 1.4 1.8 2.1 2.5
Gall bladder * * * * * * * 0.05 0.1 0.3
Anus and anorectum * * * * * * 0.06 0.2 0.6 1.4
Vagina * 0.10 * * * * * 0.1 0.2 0.3
Kaposi’s sarcoma * * * * * 0.2 0.5 0.9 1.3 1.3
Meningioma 0.09 0.2 1.4 4.4
 
Cancer Sites Age Groups
45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Colorectal 29.1 55.8 77 112 168 223.4 283.2 337.1 376.4
Pancreas 5.4 10.5 18.1 29.2 43.1 59.1 74.6 89.3 99.3
Stomach 5 7.7 11.6 17.5 26.7 36.5 45.6 55 60.3
Myelodysplastic syndromes 1 1.7 3.4 6.6 12.4 20.9 33.6 47 51.2
Lymphocytic leukemia 3.1 5.1 8.6 13.2 19.3 24.7 31.8 36.1 41.5
Vulva 2.4 3.1 3.8 4.8 6 8 10.9 14.5 17.4
Soft tissue including heart 3 3.7 4.6 5.9 7.6 9.2 11.7 13.8 14.2
Gall bladder 0.5 0.9 1.6 2.5 4.1 5.6 7.7 9.5 10.6
Anus and anorectum 2.3 3.2 3.8 4.2 4.9 5.4 5.9 6.5 6.9
Vagina 0.7 0.9 1.4 1.9 2.5 2.7 3.4 4 4.9
Kaposi’s sarcoma 1 0.6 0.5 0.4 0.6 0.8 1 1.6 2.4
Meningioma 8.4 13.8 23.4 33.4 41.8

Data from eighteen SEER registries for the years 2000–2010 were included. Cancer sites/histologies included invasive cases only, except for meningioma, and rates were per 100,000 [4]. Age-specific incidence rates for malignant and non-malignant meningioma were obtained from Central Brain Tumor Registry of the United States (CBTRUS) Statistical Report 2012: NPCR (National Program of Cancer Registries) and SEER (2004–2008) [6].

*Statistic not available due to less than 16 cases
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Figure 2

 
An external file that holds a picture, illustration, etc. Object name is nihms608316f2.jpg

SEER incidence rates (2000–2010) of top 10 cancer sites with age specific incidence rates that continue to rise in the 85+ age group, including all races and both sexes. X-axis: Cancer sites; Y-axis: Age specific IR per 100,000. Data from eighteen SEER registries for the years 2000–2010 were included [4]. Cancer sites/histologies included invasive cases only, except for meningioma, and rates were per 100,000. *Age-specific incidence rates for malignant and non-malignant meningioma were obtained from Central Brain Tumor Registry of the United States (CBTRUS) Statistical Report 2012: NPCR (National Program of Cancer Registries) and SEER (2004–2008) [6].

Table 2

Age-specific incidence rates (IR) of cancer sites that continue to increase in the 85+ age group.

Cancer Sites/histologies IR IR in
males		 IR in
females		 P value IR in
blacks		 IR in
whites		 P value
Colorectal 376.4 429.9 351.6 0.0004 394.2 413.4 0.4
Pancreas 99.3 105.7 96.3 0.5 122 95.2 0.06
Stomach 60.3 87.7 47.6 ≤0.0001 111.7 50.8 ≤0.0001
Myelodysplastic syndromes 51.2 82.4 37 ≤0.0001 43.9 52.1 0.3
Meningioma 41.8            
Lymphocytic leukemia 41.5 61.6 32.2 ≤0.0001 30.9 42.6 0.1
Vulva -- -- 17.36 -- 10.2 18.4 0.1
Soft tissue including heart 14.2 22.1 10.5 0.03 9.7 14.6 0.4
Gall bladder 10.6 8.3 11.7 0.5 12.2 10.2 0.8
Anus and anorectum 6.9 5.8 7.4 1.0 5.7 7.1 1.0
Vagina -- -- 4.95 -- 5.8 5.04 1.0
Kaposi’s sarcoma 2.4 4.4 1.4 0.4 * 2.4 --

Data from eighteen SEER registries for the years 2000–2010 were included. Cancer sites/histologies included invasive cases only, except for meningioma, and rates were per 100,000 [4]. Age-specific incidence rates for malignant and non-malignant meningioma were obtained from Central Brain Tumor Registry of the United States (CBTRUS) Statistical Report 2012: NPCR (National Program of Cancer Registries) and SEER (2004–2008) [6].

*Statistic not available due to less than 16 cases.

-- Not Applicable

 

 

 

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