Changes in survival rates and tumor characteristics with increasing age: results from population-based cancer registries

A high proportion of cancers affect individuals of older age, for whom guidelines can be used to only a limited extent due to comorbidities or other factors. Based on data from German population-based cancer registries for the period 2011-2015, this article investigates how relative survival rates, tumor stage and degree of differentiation (grade) change with increasing age in selected common cancers after the age of 60. In addition, the frequency of adjuvant chemotherapy in stage III colorectal cancer was investigated according to age and sex (data from five German federal states). Although the relative survival rates for all investigated entities decreased continuously, particularly in the age groups 65-69 and 85-89 years, the results were inconsistent in terms of the degree of differentiation and the distribution of tumor stages: invasive bladder cancer showed a trend toward earlier stages with increasing age, while the proportion of poorly differentiated tumors in gastric and lung cancer decreased. The proportion of adjuvant chemotherapies for colorectal cancer with lymph node involvement recorded in the registries declined significantly, particularly after the age of 75. Overall, the drop in relative survival rates in advanced age cannot be explained by changes in tumor characteristics alone. It is not possible to derive a definitive age limit for geriatric oncology from the available results; the survival rates in particular show a trend towards continuous changes over the 8th and 9th decades of life.