Department of Family Medicine, UConn Health, Farmington, Connecticut, USA.
Center on Aging, UConn Health, Farmington, Connecticut, USA.
J Am Geriatr Soc. 2020 Oct;68(10):2399-2406. doi: 10.1111/jgs.16791. Epub 2020 Sep 3.
The incidence of most cancers increases with age. Cancer is the second most common cause of death in older adults after cardiovascular disease. Many common cancers in older adults can be prevented from occurring or can be identified at an early stage and treated effectively. The prevention and identification of cancer in its early stages, in an attempt to reduce discomfort and disability associated with advanced cancer and cancer treatment, is also a priority. Overscreening for cancer in older adults can lead to unnecessary diagnostic testing and unnecessary treatment. Both older adults and their healthcare providers need guidance on the appropriate use of cancer prevention and screening interventions. This first of a two-part review addresses special considerations regarding cancer prevention for adults aged 65 and older. Screening decisions and the impact of limited life expectancy and an older adult's ability to tolerate cancer treatment are also addressed. Guidance is provided regarding the prevention and early identification of lung, colorectal, bladder, and kidney cancer in older adults. The prevention of breast, prostate, and female urogenital cancers are addressed in Part 2. J Am Geriatr Soc 68:2399-2406, 2020.
大多数癌症的发病率随着年龄的增长而增加。癌症是老年人除心血管疾病外的第二大常见死因。许多老年人常见的癌症可以预防发生,或可以在早期发现并有效治疗。预防和早期发现癌症,试图减少与晚期癌症和癌症治疗相关的不适和残疾,也是当务之急。对老年人进行过度筛查可能导致不必要的诊断性检查和不必要的治疗。老年人及其医疗保健提供者都需要有关癌症预防和筛查干预措施的适当使用的指导。这是两篇综述中的第一篇,介绍了 65 岁及以上成年人癌症预防的特殊考虑因素。还讨论了筛查决策以及有限的预期寿命和老年人耐受癌症治疗能力的影响。提供了有关在老年人中预防和早期发现肺癌、结直肠癌、膀胱癌和肾癌的指导。在第 2 部分中讨论了预防乳腺癌、前列腺癌和女性泌尿生殖系统癌症。美国老年医学会杂志 68:2399-2406,2020.