2017 Volume 44 Issue 2 Pages 341-348
Cancer has become the main cause of death in 1981 and various measures have been taken, but it is still a serious threat to the life and health of the people. In 2012, the number of cancer deaths was 360 thousand, which is one-third of the total death. Of those, 294,000 elderly people (81.4% of all cancer deaths) accounted for more than aged 65 or over, and 207,000 people (57.2% of all cancer deaths) accounted for over 75 years old. Meanwhile, late elderly people are excluded in “the reduction of deaths due to cancer (age-adjusted mortality rate under 75 years old: 20%)” which is the goal of the Basic Plan to Promote Cancer Control Programs. Also, in cancer screening rate targeting 50%, subjects to be counted are limited to 40 to 69 years old. However in cancer screening the upper limit of age is not set. It should be an appropriate target considering the balance between the benefits and disadvantages of screening in the elderly.
The idea of treatment for the elderly depends on whether the time of cancer death will happens before the average life expectancy or not. If it is predicted “yes”, evaluate physical function, daily activity level, cognitive function, etc. If he (she) has no problem, perform the standard treatment as non-elderly people. If he has a serious problem, select supportive or palliative care. If he has a problem, but some treatment is possible, select a treatment suitable for each patient. Development of new minimally invasive treatment based on the characteristics of elderly cancer is desired.
The “Cancer Registration Promotion Act” was implemented since 2016, and nationwide cancer registration began. It is possible to grasp the incidence and survival rate of all type cancers as measured values. In addition, it is expected that the detailed situation of elderly cancer will be clarified. It is hoped that it will contribute to setting goals for cancer prevention/treatment and outcome evaluation.
