Cancer is a Disease of Aging
The greatest risk factor for developing cancer is age: Sixty percent of new cancer diagnoses are made in adults aged 65 and older, and 70% of cancer deaths occur in this population.1 There is an anticipated 67% increase in cancer incidence among individuals aged 65 and older from 2010 to 2030.2
The Population of Older Adults is Growing
By 2030, 20% of the U.S. population will be over 65, reaching 98 million individuals by 2060. This will increase the percentage of older adults from 15% to nearly 24% of the U.S. population.3 Further, there is a projected global increase of the “oldest old”—individuals over 85 years old—of 151% from 2005 to 2030.4
According to information from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, associated costs of cancer care are expected to reach $173 billion by 2020, up 39% from 2010.5
Underrepresentation in Research
From 2007 to 2010, 24 drugs were approved for the treatment of cancer. According to the geriatric usage sections of the drug package inserts, on average, only 33% of patients included in the registration trials were aged 65 years or older, despite 59% of the cancer population being aged 65 years or older.6 This means that treatment for the majority of cancer patients is developed through trials on a younger, healthier cohort with very different physiologic and functional age. Because of this, physicians have very little evidence on how to treat the majority of patients with cancer.
Lack of Healthcare Providers
There is currently only one geriatrician for every 2,725 Americans aged 75 or older; this ratio is expected to drop to one geriatrician for every 4,567 American by 2030.7 Just as pediatric patients have specialized doctors trained to meet their unique healthcare needs, so too are specialized physicians required to understand the complex healthcare needs of older adults.
The Bottom Line
As older adults increasingly comprise a larger proportion of the U.S. population, incidence of cancer will proliferate. We need a quality workforce, an allocated budget, and better research to prepare.
1 Ries LAG, Harkins D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Eisner MP, Horner MJ, Howlader N, Hayat M, Hankey BF, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2003, National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2003/, based on November 2005 SEER data submission, posted to the SEER web site, 2006.
2 Smith BD, Smith GL, Hurria A, Hortobagyi GN, Bucholz TA. Future of cancer incidence in the United States: Burdens upon an aging, changing nation. J Clin Oncol, 2009 June 10;27(17):2758-65.
3 Mather M, Jacobsen LA, Pollard KM. Population Bulletin: Aging in the United States, 2015. http://www.prb.org/pdf16/aging-us-population-bulletin.pdf
4 United Nations Department of Economic and Social Affairs, population Division, World Population Prospects, 2005.
5 Mariotto AB, Yabroff R, Shai Y, Feuer EJ, Brown ML. “Projections of the Cost of Cancer Care in the United States: 2010-2020.” J Natl Cancer Inst. 2011;103(8):699.PMC3107566
6 KS Scher, Hurria A. Under-representation of older adults in cancer registration trials: Known problem, little progress. J Clin Oncol, 2012;30:2036–2038.
7 Current and Projected Future Doctor to Patient Ratios. American Geriatrics Society. April 2017. http://www.americangeriatrics.org/advocacy_public_policy/gwps/gwps_faqs/id:3188