Cancer incidence, prevalence and survival in an aging Norwegian population

Abstract

Background: Cancer is a disease closely associated with aging. Aging populations will thus lead to a pronounced increase in the absolute number of elderly persons with cancer, resulting in profound public health challenges in the coming decades. Older patients have distinct treatment and care needs, but are nevertheless largely overlooked in studies. We therefore examine cancer incidence, prevalence and survival among older cancer patients to help guide various stakeholders in the acute and more long-term handling of this patient group.

Data and methods: >400 000 cancers diagnosed in individuals age 65+ in 1975-2009 were extracted from the Cancer Registry of Norway. Descriptive analyses of incidence and prevalence were undertaken, and survival analysis was used to model survival.

Results: The absolute number of elderly (65-79 years) and oldest old (80+ years) patients has more than doubled since 1975, and will continue to grow towards 2030. A more than threefold increase in patients 80+ years has taken place. The largest patients groups comprise colorectal, prostate, lung and breast cancer. For all patients 65 and older, the median survival has increased with 135%. The increase has been most pronounced for the elderly patients. Surgical resection rates decline with increasing patient age. The difference in relative survival is around 8 percentage points at three years (60% vs 52%). It has been constant over time.

Conclusion: “Best practice” guidelines for the large and increasing group of older cancer patients remain to be established. The gain in length of lives must be balanced against patients’ quality of life, and considered in a cost-benefit perspective for society at large.