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智利肿瘤老年医学实施的考量与分析及其重要性:当前文献综述

Considerations and analysis of the implementation of oncogeriatrics in Chile and its importance: Review of current literature.

作者信息

Honorato Macarena, Calderón Oscar, Rojas Verónica, Fasce Gerardo, Bartolotti Constanza, Caglevic Christian

机构信息

Geriatrics Department, Clínica Alemana de Santiago, Santiago, Chile.

Geriatrics, Complejo Asistencial Dr Sótero del Río, Santiago, Chile.

出版信息

Front Aging. 2023 Mar 23;4:1141792. doi: 10.3389/fragi.2023.1141792. eCollection 2023.

Abstract

The Chilean census of 2017 reported that 11.4% of the local population are 65 years or older, and according to the National Institute of Statistics (INE) the current expectancy of life in Chile is 76 years for men and 81 years for women respectively. Cancer in Chile is a major public health problem. Aging is a significant risk factor for cancer development which added to the improved life expectancy, it increases the incidence of cancer. In 2040, new cancer cases will increase from 19.3 to 30.2 million worldwide. Older people are a heterogeneous group requiring specialized and individualized management. Chronological age does not necessarily correlate with physiological age. More than half of the geriatric patients with cancer have at least one comorbidity which is relevant when defining a cancer treatment. Likewise, polypharmacy is frequent and is an important issue to consider in people with cancer due to the risk associated with drug interactions. Oncogeriatric assessment consists of a comprehensive multidimensional evaluation, including functional and biopsychosocial issues, addressing aspects of the neoplastic disease such as the risk of toxicities due to systemic therapy and life expectancy. This tool has proven to be helpful in the diagnosis of conditions that are not evident in a routine oncological evaluation, such as geriatric syndromes, frailty, functional dependence, and cognitive impairment among others, which have an impact when deciding on therapy, predicting risks of treatment toxicity and mortality. In this article we aim to describe the current situation of Oncogeriatrics and to provide epidemiological information about cancer in the elderly population in Chile attempting to highlight the importance of the Oncogeriatrics units, within cancer departments, for a better decision taking in the elderly cancer patient.

摘要

2017年智利人口普查报告称,当地11.4%的人口年龄在65岁及以上。根据国家统计局(INE)的数据,智利目前男性的预期寿命为76岁,女性为81岁。癌症在智利是一个重大的公共卫生问题。衰老作为癌症发生的一个重要风险因素,再加上预期寿命的提高,导致癌症发病率上升。到2040年,全球新增癌症病例将从1930万增至3020万。老年人是一个异质性群体,需要专门的个体化管理。实际年龄不一定与生理年龄相关。超过半数的老年癌症患者至少有一种合并症,这在确定癌症治疗方案时很重要。同样,多重用药很常见,鉴于药物相互作用的风险,这也是癌症患者需要考虑的一个重要问题。老年肿瘤评估包括全面的多维度评估,涵盖功能和生物心理社会问题,涉及肿瘤疾病的各个方面,如全身治疗的毒性风险和预期寿命。事实证明,该工具有助于诊断常规肿瘤评估中不明显的病症,如老年综合征、虚弱、功能依赖和认知障碍等,这些在决定治疗方案、预测治疗毒性风险和死亡率时都会产生影响。在本文中,我们旨在描述老年肿瘤学的现状,并提供智利老年人群体癌症的流行病学信息,试图强调癌症科室中设立老年肿瘤学单元对于更好地为老年癌症患者做出决策的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a67/10077059/d06d266f35af/fragi-04-1141792-g001.jpg

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