Declining cancer incidence at the oldest ages

Hallmark of aging or lower diagnostic activity?

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: The incidence of most cancers increases with age from early adulthood into old age but tends to level off or decrease at the highest ages. This decline may be caused by age-related mechanisms or due to lower diagnostic activity, leaving some cancers undiagnosed at the oldest ages.

METHODS: For breast, colon, lung, and all sites except non-melanoma skin cancer, age-specific incidence rates of verified as well as suspected cancer were estimated up to ages 95+ years for a random sample of the Danish population, 1994-2011, based on nationwide health registers (40,008 verified and 9110 suspected cancers). Moreover, for cancers diagnosed in Denmark, 1978-2012 (613,384 cancers), age-specific percentages of tumors with microscopic verification (histological/cytological/hematological examination) were calculated.

RESULTS: The age-specific cancer incidence rates reached a peak between ages 65-89 years after which rates declined. The corresponding incidence pattern of suspected but not verified cancer was similar, with a trend of a slight absolute and relative decrease with age compared to verified cancer incidence. The proportion of cancers with microscopic verification decreased linearly from approximately 95% at ages 0-69 years all years to 70% (1978-1982) and to 80% (2010-2012) at ages 90+ years.

CONCLUSIONS: The lower diagnostic verification of cancer at the highest ages suggests a lower diagnostic activity among the oldest-old. However, the proportion of suspected but not verified cancers did not increase with age, possibly partially due to lack of registration. The declining cancer incidence at oldest ages is probably partly due to lower diagnostic activity.

OriginalsprogEngelsk
TidsskriftJournal of Geriatric Oncology
Vol/bind10
Udgave nummer5
Sider (fra-til)792-798
ISSN1879-4068
DOI
StatusUdgivet - sep. 2019

Fingeraftryk

Incidence
Neoplasms
Skin Neoplasms
Denmark
Colon
Lung
Health
Population

Citer dette

@article{0cc2396b8bae4c2d9ec29d60e414e0f4,
title = "Declining cancer incidence at the oldest ages: Hallmark of aging or lower diagnostic activity?",
abstract = "BACKGROUND: The incidence of most cancers increases with age from early adulthood into old age but tends to level off or decrease at the highest ages. This decline may be caused by age-related mechanisms or due to lower diagnostic activity, leaving some cancers undiagnosed at the oldest ages.METHODS: For breast, colon, lung, and all sites except non-melanoma skin cancer, age-specific incidence rates of verified as well as suspected cancer were estimated up to ages 95+ years for a random sample of the Danish population, 1994-2011, based on nationwide health registers (40,008 verified and 9110 suspected cancers). Moreover, for cancers diagnosed in Denmark, 1978-2012 (613,384 cancers), age-specific percentages of tumors with microscopic verification (histological/cytological/hematological examination) were calculated.RESULTS: The age-specific cancer incidence rates reached a peak between ages 65-89 years after which rates declined. The corresponding incidence pattern of suspected but not verified cancer was similar, with a trend of a slight absolute and relative decrease with age compared to verified cancer incidence. The proportion of cancers with microscopic verification decreased linearly from approximately 95{\%} at ages 0-69 years all years to 70{\%} (1978-1982) and to 80{\%} (2010-2012) at ages 90+ years.CONCLUSIONS: The lower diagnostic verification of cancer at the highest ages suggests a lower diagnostic activity among the oldest-old. However, the proportion of suspected but not verified cancers did not increase with age, possibly partially due to lack of registration. The declining cancer incidence at oldest ages is probably partly due to lower diagnostic activity.",
keywords = "Aged, Aged, 80 and over, Bias, Epidemiology, Incidence, Neoplasms",
author = "Pedersen, {Jacob K} and Jens-Ulrik Rosholm and Marianne Ewertz and Gerda Engholm and Rune Lindahl-Jacobsen and Kaare Christensen",
note = "Copyright {\circledC} 2019. Published by Elsevier Ltd.",
year = "2019",
month = "9",
doi = "10.1016/j.jgo.2019.02.001",
language = "English",
volume = "10",
pages = "792--798",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Declining cancer incidence at the oldest ages

T2 - Hallmark of aging or lower diagnostic activity?

AU - Pedersen, Jacob K

AU - Rosholm, Jens-Ulrik

AU - Ewertz, Marianne

AU - Engholm, Gerda

AU - Lindahl-Jacobsen, Rune

AU - Christensen, Kaare

N1 - Copyright © 2019. Published by Elsevier Ltd.

PY - 2019/9

Y1 - 2019/9

N2 - BACKGROUND: The incidence of most cancers increases with age from early adulthood into old age but tends to level off or decrease at the highest ages. This decline may be caused by age-related mechanisms or due to lower diagnostic activity, leaving some cancers undiagnosed at the oldest ages.METHODS: For breast, colon, lung, and all sites except non-melanoma skin cancer, age-specific incidence rates of verified as well as suspected cancer were estimated up to ages 95+ years for a random sample of the Danish population, 1994-2011, based on nationwide health registers (40,008 verified and 9110 suspected cancers). Moreover, for cancers diagnosed in Denmark, 1978-2012 (613,384 cancers), age-specific percentages of tumors with microscopic verification (histological/cytological/hematological examination) were calculated.RESULTS: The age-specific cancer incidence rates reached a peak between ages 65-89 years after which rates declined. The corresponding incidence pattern of suspected but not verified cancer was similar, with a trend of a slight absolute and relative decrease with age compared to verified cancer incidence. The proportion of cancers with microscopic verification decreased linearly from approximately 95% at ages 0-69 years all years to 70% (1978-1982) and to 80% (2010-2012) at ages 90+ years.CONCLUSIONS: The lower diagnostic verification of cancer at the highest ages suggests a lower diagnostic activity among the oldest-old. However, the proportion of suspected but not verified cancers did not increase with age, possibly partially due to lack of registration. The declining cancer incidence at oldest ages is probably partly due to lower diagnostic activity.

AB - BACKGROUND: The incidence of most cancers increases with age from early adulthood into old age but tends to level off or decrease at the highest ages. This decline may be caused by age-related mechanisms or due to lower diagnostic activity, leaving some cancers undiagnosed at the oldest ages.METHODS: For breast, colon, lung, and all sites except non-melanoma skin cancer, age-specific incidence rates of verified as well as suspected cancer were estimated up to ages 95+ years for a random sample of the Danish population, 1994-2011, based on nationwide health registers (40,008 verified and 9110 suspected cancers). Moreover, for cancers diagnosed in Denmark, 1978-2012 (613,384 cancers), age-specific percentages of tumors with microscopic verification (histological/cytological/hematological examination) were calculated.RESULTS: The age-specific cancer incidence rates reached a peak between ages 65-89 years after which rates declined. The corresponding incidence pattern of suspected but not verified cancer was similar, with a trend of a slight absolute and relative decrease with age compared to verified cancer incidence. The proportion of cancers with microscopic verification decreased linearly from approximately 95% at ages 0-69 years all years to 70% (1978-1982) and to 80% (2010-2012) at ages 90+ years.CONCLUSIONS: The lower diagnostic verification of cancer at the highest ages suggests a lower diagnostic activity among the oldest-old. However, the proportion of suspected but not verified cancers did not increase with age, possibly partially due to lack of registration. The declining cancer incidence at oldest ages is probably partly due to lower diagnostic activity.

KW - Aged

KW - Aged, 80 and over

KW - Bias

KW - Epidemiology

KW - Incidence

KW - Neoplasms

U2 - 10.1016/j.jgo.2019.02.001

DO - 10.1016/j.jgo.2019.02.001

M3 - Journal article

VL - 10

SP - 792

EP - 798

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

SN - 1879-4068

IS - 5

ER -