Cancer screening in the elderly: A challenge for the twenty-first century

THE PROJECTED increase in the elderly population has major implications for cancer care, because 55% of all malignancies occur in people over 65 and the incidence increases markedly with age, peaking at 85 years. Cancer is the second leading cause of death in the elderly. Although mortality for those under age 55 has been decreasing over recent years, the rate for patients over 65 has been rising. Detection of cancer in the elderly is thus important, but older persons have a disappointing compliance rate with cancer screening. Barriers to screening in this group involve provider forgetfulness, insufficient time, inconvenience, disorganized medical records, delayed or indirect gratification from screening, and lack of reimbursement among health care providers and within the health care system, as well as social and behavioral factors in the elderly. Inducing health care providers to bring cancer screening techniques into their practice and increasing the utilization of cancer screening tests by older persons present challenges for the future.