Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China.
Cancer Med. 2024 Aug;13(15):e70062. doi: 10.1002/cam4.70062.
Cancer burden from the elderly has been rising largely due to the aging population. However, research on the long-term epidemiological trends in cancer of the elderly is lacking.
Registry data of this population-based cross-sectional study were from the Surveillance, Epidemiology, and End Results (SEER) database. The study population aged 65 years or more, from geographically distinct regions. Joinpoint regression and JP Surv method were used to analyze cancer trends and survival.
Mortality rate during 1975-2020 decreased from 995.20 to 824.99 per 100,000 elderly persons, with an average annual decrease of 0.421% (95% CI, 0.378-0.464). While overall incidence increased with no significance. Prostate (29%) and breast (26%) cancer were the most common malignancies, respectively, in elderly males and females, and the mortality for both of the two (prostate 15%, breast 14%) ranked just behind lung and bronchus cancer, which had the highest mortality rates in males (29%) and females (23%). Many cancers showed adverse trends in the latest follow-up periods (the last period calculated by the Joinpoint method). For intrahepatic cholangiocarcinoma, incidence (male Annual Percentage Change [APC] = 7.4*; female APC = 6.7*) and mortality (male APC = 3.0*; female APC = 3.3*) increased relatively fast, and its survival was also terrible (3-year survival only 10%). Other cancers with recent increasing mortality included cancer of anus, anal canal and anorectum, retroperitoneum, pleura, peritoneum, etc. Most cancers had favorable trends of survival during the nearest follow-up period.
Against the background of overall improvement, many cancers showed adverse trends. Further research for the underlying mechanisms and targeted implements towards adverse trends is also urgent.
由于人口老龄化，老年人的癌症负担一直在增加。然而，缺乏关于老年人癌症的长期流行病学趋势的研究。
本基于人群的横断面研究的登记数据来自监测、流行病学和最终结果 (SEER) 数据库。研究人群为年龄在 65 岁及以上、来自不同地理区域的人群。使用 Joinpoint 回归和 JP Surv 方法分析癌症趋势和生存率。
1975 年至 2020 年期间，死亡率从每 10 万名老年人 995.20 人下降到 824.99 人，平均年下降 0.421%（95%CI，0.378-0.464）。而总体发病率则没有显著增加。在老年男性和女性中，前列腺癌（29%）和乳腺癌（26%）分别是最常见的恶性肿瘤，而这两种癌症的死亡率（前列腺癌 15%，乳腺癌 14%）仅次于肺癌和支气管癌，这两种癌症在男性（29%）和女性（23%）中的死亡率最高。许多癌症在最近的随访期内呈现出不利趋势（最后一个由 Joinpoint 方法计算的随访期）。对于肝内胆管癌，发病率（男性年度百分比变化 [APC] = 7.4*；女性 APC = 6.7*）和死亡率（男性 APC = 3.0*；女性 APC = 3.3*）增长相对较快，其生存率也很糟糕（3 年生存率仅为 10%）。其他死亡率最近有所增加的癌症包括肛门、肛管和肛门直肠癌、腹膜后、胸膜、腹膜等。在最近的随访期间，大多数癌症的生存率呈良好趋势。
在整体改善的背景下，许多癌症呈现出不利趋势。针对不利趋势的潜在机制和有针对性的措施也亟待研究。
