Abstract
The incidence and the mortality of cancer increase with age. This article explores the possibility of decreasing cancer-related mortality in the aged with secondary prevention of cancer deaths that entails early diagnosis of cancer through the screening of asymptomatic older individuals.We establish that screening of asymptomatic individuals should be based on physiologic rather than chronologic age that may be estimated from a comprehensive geriatric assessment and possibly with the utilization of biologic markers of aging.
Highlights
Worldwide, the incidence and prevalence of cancer increase with age [1]
The Surveillance Epidemiology and End Results (SEER) data on mammography have demonstrated the usefulness of registry databases in providing information on long-term mortality risk and survival of older individuals following cancer screening
Practical approach to screening older individuals for cancer based on current evidence In Figure 1 we propose a decisional tree to establish which older individuals may benefit from cancer screening
Summary
The incidence and prevalence of cancer increase with age [1]. In the meantime the risk of cancerrelated mortality increases with age at diagnosis [2,3,4]. A systematic review of 8 randomized controlled studies [14] indicates that a 15% approximate reduction in mortality risk may be obtained by screening asymptomatic women for breast cancer ages 50-69 with serial mammograms. We believe that life expectancy and tolerance of treatment should determine the decision of screening older individuals, more so than chronologic age.
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