Epidemiology in Europe

Abstract

The topic ‘Cancer in the elderly’ will become increasingly important on the agendas of public health, clinical medicine and research, because the demand for oncological, medical and psychosocial care is rising steadily. Predictably, in most European countries, the peak will only be seen after 2030, resulting in more patients of an older age with more complex medical, psychological and social problems. The fact that there are less care providers because of the declining birth rates since the 1960’s (earlier in some countries) could result in a critical situation, which can only be avoided by oncological and/or social breakthroughs. This contribution deals with the major quantitative components and determinants of incidence and survival and, thus, also assesses the potential for primary and secondary prevention (as usual, in the long-term) and adequate management (in the short-term). The following questions will be addressed: (1) which cancers occur mainly in the elderly? (2) can they be prevented based on current knowledge of risk factors and when or on what terms? (3) can the cancers (from question 1) be detected early enough to apply curative treatments? (4) what are, in addition to stage and biological type, the major determinants of prognosis from a clinico-epidemiological viewpoint? The emerging demographic situation in most European countries will be described briefly as being essential for an estimation of demand and the need for investments in supply of care, both ‘caremanpower’ and facilities.