Avis Nancy E, Deimling Gary T
Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
Cancer. 2008 Dec 15;113(12 Suppl):3519-29. doi: 10.1002/cncr.23941.
Cancer is primarily a disease of the elderly. Greater than 60% of new cancers occur in people aged >65 years, and 60% of the current 10 million cancer survivors are aged > or =65 years. Given these large numbers and the potential vulnerability of older adults, older cancer survivors have become an especially important group to study. This article discusses published research on the physical and mental functioning of older cancer survivors. In the first part, the authors reviewed studies of those who are newly diagnosed at the age of > or =65 years. The second part reviewed the research regarding long-term (> or =5 years) cancer survivors who are aged >65 years, but may have been diagnosed at a younger age. Older survivors are likely to be more affected by cancer in terms of physical than psychologic function. However, comparisons with individuals without a history of cancer suggest that older cancer survivors may be faring worse physically and psychologically than noncancer comparison groups. For older cancer survivors, cancer occurs against a background of other chronic conditions and normal aging, and comorbidities and symptoms are important factors to consider. Limitations of the research were discussed, and recommendations for future research were provided. In particular, prospective studies with measures of functioning before cancer diagnosis and treatment, comparisons with age-matched noncancer populations, and interventions to reduce the impact of cancer on functioning are needed.
癌症主要是一种老年疾病。超过60%的新发癌症发生在65岁以上的人群中，目前1000万癌症幸存者中有60%的年龄在65岁及以上。鉴于这一庞大的数量以及老年人潜在的脆弱性，老年癌症幸存者已成为一个特别重要的研究群体。本文讨论了已发表的关于老年癌症幸存者身体和心理功能的研究。在第一部分，作者回顾了那些年龄在65岁及以上新诊断癌症患者的研究。第二部分回顾了关于年龄在65岁以上、但可能在较年轻时被诊断出癌症的长期（≥5年）癌症幸存者的研究。老年幸存者在身体功能方面可能比心理功能更易受到癌症的影响。然而，与无癌症病史的个体相比，老年癌症幸存者在身体和心理方面的状况可能比非癌症对照组更差。对于老年癌症幸存者来说，癌症是在其他慢性疾病和正常衰老的背景下发生的，合并症和症状是需要考虑的重要因素。文中讨论了该研究的局限性，并提供了对未来研究的建议。特别是，需要开展前瞻性研究，测量癌症诊断和治疗前的功能状况，与年龄匹配的非癌症人群进行比较，并采取干预措施以减轻癌症对功能的影响。
