O'Hanlon Shane
Department of Geriatric Medicine, Mater Private Network, Eccles St, Dublin, Ireland.
University College Dublin, School of Medicine, Dublin 4, Ireland.
Age Ageing. 2025 May 3;54(5). doi: 10.1093/ageing/afaf113.
Cancer disproportionately affects older adults, who account for the majority of diagnoses and deaths globally. However, research and clinical care often fail to adequately address their unique needs. This collection of studies in Age and Ageing highlights challenges and opportunities in geriatric oncology. The rising incidence of cancer in the older population, driven by demographic shifts and socioeconomic factors, underscores the need for targeted prevention and control strategies. Despite this, older adults remain underrepresented in clinical trials, with barriers including social isolation, healthcare professionals' biases and a lack of dedicated studies. Frailty assessment is gaining ground as a key tool in geriatric oncology. Studies on frailty scores such as the Hospital Frailty Risk Score, and comprehensive geriatric assessment (CGA), show their ability to predict outcomes and guide interventions. CGA-based care has been shown to reduce treatment toxicity without compromising survival, yet its integration into routine practice remains limited. Treatment challenges are common, particularly with novel therapies like immune checkpoint inhibitors, which carry age-specific risks of adverse events. Tailored services are essential to address the diverse needs of older cancer patients. Research highlights the importance of improving communication around cancer screening for older adults and developing specialised care pathways for vulnerable populations, such as those with dementia. Continuity of care remains a significant challenge, requiring better coordination across healthcare providers. These findings emphasise the urgent need for age-attuned research, frailty-informed care models and tailored interventions to improve outcomes for older adults with cancer.
癌症对老年人的影响尤为严重，全球大多数癌症诊断病例和死亡病例都发生在老年人身上。然而，研究和临床护理往往未能充分满足他们的独特需求。《衰老与老年医学》（Age and Ageing）上的这组研究突出了老年肿瘤学中的挑战与机遇。人口结构变化和社会经济因素导致老年人群中癌症发病率不断上升，这凸显了制定针对性预防和控制策略的必要性。尽管如此，老年人在临床试验中的代表性仍然不足，存在的障碍包括社会孤立、医护人员的偏见以及缺乏专门研究。衰弱评估作为老年肿瘤学的一项关键工具正逐渐得到认可。关于医院衰弱风险评分等衰弱评分以及综合老年评估（CGA）的研究表明，它们有能力预测预后并指导干预措施。基于CGA的护理已被证明可以降低治疗毒性且不影响生存率，但其在常规实践中的整合仍然有限。治疗挑战很常见，尤其是对于免疫检查点抑制剂等新型疗法，这类疗法存在特定年龄的不良事件风险。量身定制的服务对于满足老年癌症患者的多样化需求至关重要。研究强调了改善针对老年人癌症筛查的沟通以及为痴呆症患者等弱势群体制定专门护理途径的重要性。护理的连续性仍然是一项重大挑战，需要医疗服务提供者之间更好地协调。这些发现强调了迫切需要开展适合年龄的研究、基于衰弱情况的护理模式以及量身定制的干预措施，以改善老年癌症患者的预后。
