Cancer in the older population of the Czech Republic

Epidemiology of the most common cancers in the Czech population aged over 70 is described in a study which has recently been published in the European Journal of Cancer Care [1]. Leading Czech oncologists and their colleagues analysed data from the Czech National Cancer Registry [2] from the period 2006–2010 on cancer patients aged over 70. A similar analysis has been performed over data from the period 2008–2012, and its results have been published in a dedicated chapter [3] of the book Geriatrická onkologie (Geriatric Oncology; the book is available in Czech language only).

Both analyses evaluated epidemiological parameters of 10 most common cancers:

• colorectal cancer (C18–C20),
• pancreatic cancer (C25),
• head and neck cancer (C00–C14, C30–C32),
• lung cancer (C34),
• breast cancer in women (C50),
• prostate cancer (C61),
• kidney cancer (C64),
• stomach cancer (C16),
• malignant melanoma of skin (C43),
• gynaecological cancers (C53–C56).

Cancer burden of the older population is highlighted by age-specific incidence rates of various cancer types. Age is one of the most important risk factors in most cancers, which is reflected in all evaluated diagnoses (Fig. 1).

Figure 1: Age-specific incidence rates of cancer in the period 2008–2012 (click on the image to enlarge it).
Source: Czech National Cancer Registry

Results of both analyses [1, 3] are rather similar, and the main conclusions are as follows:

• The overall incidence rates of cancer in the population aged over 70 have increased (by 1.8% on average between 2008 and 2012).
• Patients aged 70 and above represent more than 40% of all new cancer cases, and approximately 50% of all cancer deaths.
• Cancer patients aged 70 and over have a significant tendency to higher mortality rates and shorter survival than younger patients.

Furthermore, the first study [1] highlighted that there is a lack of consensus on guidelines for the older population due to its underrepresentation in clinical trials. Geriatric assessments should be made in order to decide whether a given patient should undergo a standard treatment or an adapted treatment, or whether he/she should be indicated for palliative care; such assessments should serve as guidelines for treatment decisions, helping to establish a comprehensive plan of cancer care. However, there is a lack of studies which would confirm the benefit of this procedure when compared to routine oncology practice. The study authors pointed out that clinical trials focused on older cancer patients are urgently needed.

Due to population ageing (and therefore a continuously growing cancer burden) in most economically developed countries, governments and health authorities of these countries have been made to pay particular attention to cancer. High-quality epidemiological data are essential to any analysis of health care: the Czech National Cancer Registry (CNCR) [2] is used in the Czech Republic to collect and to evaluate data on cancer patients. CNCR is an essential component of the Czech National Cancer Control Programme, making it possible to evaluate the current cancer burden, to predict the future cancer burden, and to evaluate the survival of cancer patients, among others.

Reference

1. Petera J, Dušek L, Sirák I, Soumarová R, Jarkovský J. Cancer in the elderly in the Czech Republic. European Journal of Cancer Care 2015; 24(2): 163–178. doi: 10.1111/ecc.12287.
2. Institute of Health Information and Statistics of the Czech Republic: Czech National Cancer Registry (CNCR) [9. 9. 2014]. http://www.uzis.cz/registry-nzis/nor
3. Dušek l, Petera J, Malúšková D, Mužík J, Pavlík T, Jarkovský J, Koptíková J, Gregor J, Abrahámová J. Epidemiologie zhoubných nádorů u seniorů. In: Matějovská Kubešová H, Kiss I et al. Geriatrická onkologie. Praha: Mladá fronta 2015, p. 47–64. ISBN 978-80-204-3738-9 (chapter in a book, available in Czech language only)

Keywords: older population, cancer, age-specific incidence rates of cancer

27. 10. 2015 IBA MU

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