NCI and NIA Launch New Efforts to Explore the Interface of Aging and Cancer

Introduction

The risk of developing cancer significantly increases with age and -- as the population of older Americans expands in the next decade -- the cancer burden will escalate. Here are the facts:

• Close to 60 percent of all new cancers and 70 percent of deaths from cancer are in persons older than 65.

• Research shows that older patients differ from younger patients in their susceptibility to disease progression and their response to treatment.

• Current healthcare practices frequently fall short of providing the best available early detection, treatment protocols, and quality care for aging patients.

• As increasing numbers of older people develop cancer, and younger cancer survivors live to an older age, the ranks of survivors will grow. The difficulties this group will experience include a greater chance of developing other health problems, disabling conditions, and recurrent cancers.

All of these factors point to a clear need to continue to advance our understanding of the relationships between aging and the development and progression of cancer.

In addition to numerous studies referenced throughout this document, NCI and the National Institute on Aging (NIA) have partnered to further invigorate the research community's focus on the intersection of aging and cancer. Two separate initiatives, one directed to the scientific community at large and the other to NCI-designated Cancer Centers, will support efforts in seven areas of emphasis that emerged from the 2001 NCI/NIA Cancer Centers Workshop on Integrating Aging and Cancer Research.

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Areas of Emphasis

Biology of Aging and Cancer. Researchers will broaden studies of genetics, molecular signatures, age-related changes that contribute to mortality, and vulnerability versus resilience in older patients. The work will include studies in human biology that reveal which aspects of tumor biology and tumor growth vary by age.

Patterns of Care. Investigators will expand efforts to identify and analyze existing and new data from numerous sources, including studies focusing on communities, patient management, and specific cancer sites. The goal of these patterns-of-care studies is to determine current cancer care practices and identify where changes are needed to improve the quality of care for older patients.

Treatment Efficacy and Tolerance. Researchers will focus renewed efforts on:

• Investigating the effectiveness of available treatments, including radiation therapy, surgery, and standard technology.
• The pharmacology of anti-cancer drugs.
• Limitations on admitting older patients to clinical trials.
• Age-related treatment outcomes.
• Methods to prevent or offset unfavorable outcomes in older persons.

The Effects of Comorbidity. New studies will further demonstrate or verify effective management of older cancer patients with pre-existing chronic conditions and concurrent diseases, including secondary cancers.

Prevention, Risk Assessment, and Screening. Investigators will increase efforts to identify the impediments that prevent older people, both with and without symptoms, from receiving preventive, assessment, and screening services.

Psychosocial Issues and Medical Effects. Researchers will determine the characteristics of early and late effects of treatment, quality cancer care, tumor recurrence, and multiple primary tumors in older patients, and develop interventions to improve quality of life, cancer survival, and family and caregiver resources.

Symptom Management and Palliative Care. Researchers will focus on the development of evidence-based interventions and guidelines for the management of pain and other symptoms in patients with cancer, as well as family and caregiver support.

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Percent of Cancer Deaths in the United States Among People 65 Years and Older

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