肿瘤发生比率在85岁以前一般随年龄增长而增长，85岁以后肿瘤总的发病率降低，但有些肿瘤尤其消化道肿瘤仍然增加

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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 Copyright/License ?Request permission to reuse

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肿瘤发生比率在85岁以前一般随年龄增长而增长，85岁以后肿瘤总的发病率降低，但有些肿瘤尤其消化道肿瘤仍然增加

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

 

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

 

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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