Non-Small Cell Lung Cancer in the Elderly: a Practical Approach to Screening, Diagnosis, and Treatment

Abstract

Lung cancer is primarily a disease of the elderly. We summarize the literature on screening, diagnosis, and treatment of early non-small cell lung cancer in the elderly population. Lung cancer screening has resulted in a reduction in lung cancer mortality and is recommended in some patients up to 80 years old. Minimally invasive techniques, such as endobronchial ultrasound guided biopsy, have allowed for low diagnostic complications rates in elderly patients. Surgical treatment remains the standard of care; however, stereotactic body radiation therapy in non-operative candidates has similar outcomes with less morbidity. Decision to treat and choice of treatment should not be based on age alone, but should incorporate functional status, comorbid disease, and patient preference. Advances in screening, diagnostic techniques, and radiation therapies have transformed the management of early non-small cell lung cancer in the elderly. Further studies are needed incorporating larger numbers of geriatric patients in a disease that primarily affects the elderly.