The epidemiology of colorectal cancer in older patients
One of the most commonly diagnosed types of cancer at an older age is colorectal cancer (CRC). The median age at which CRC is diagnosed nowadays is 69 years. Due to the aging of the population and the fact that individuals between 80–89 years exhibit the highest risk of being diagnosed with CRC, the median age at diagnosis will further increase in the near future. An important feature of elderly cancer patients is the fact that they often present with comorbidity. Among patients with CRC, the prevalence of comorbidity has been increasing over the last decades. Among patients aged 80–89 years old the prevelance of comorbidity increased from almost 60% in 1995–1998 to 80% in 2007–2010. Also tumor location shows a relation with age. With the exception of appendiceal tumours, older age is related to a more proximal tumor location within the large bowel. Older patients are less often diagnosed with node positive disease, as wel as synchronous distant metastases. Also socio-economic status of patients with CRC shows a strong relation with age. Of patients younger than 55 years, 18% of the patients is of a low socio-economic status, while this amounts to 42% among patients aged 80 or above. Five-year elative survival of patients with CRC decreases by age, from 66% for patients younger than 45 years old, to 55% for patients older than 75 years. Survival has been improving recently also for elderly patients. This, together with the increase in incidence, will lead to an increased prevalence of elderly with CRC. This development will increasingly ask for investments in clinicalresearch and infrastructure with a special attention for the elderly patient with CRC.