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APHA Scientific Session and Event Listing

Recorded presentation

Laurie A. MacDougall, MS, Susan T. Gershman, PhD, and Richard Knowlton, MS. Massachusetts Cancer Registry, Massachusetts Department of Public Health, 250 Washington Street, 6th floor, Boston, MA 02108-4619, 617-624-5602, laurie.macdougall@state.ma.us

Background and Objectives: The “oldest old,” defined as those aged 85 and older, are the fastest growing segment of the population. As cancer is a disease of aging, we would expect to see the highest incidence rates among this group. However, previous research has suggested that patterns of cancer incidence differ between this group and other elders (ages 65-84), with incidence rates declining in the oldest age group. This presentation examines the distribution and characteristics of cancer diagnoses in Massachusetts elders. Data Sources: Cancer incidence and stage at diagnosis: Massachusetts Cancer Registry, 1999-2003. Mortality: Massachusetts Registry of Vital Records and Statistics, 1999-2003. Results: Overall, and for many leading cancers, the incidence rate among those aged 85+ is significantly lower than for those aged 75-84. This pattern does not hold for cancer mortality, in which most cancers reach their highest mortality rates among the oldest age groups. Stage of diagnosis patterns suggest that those aged 85+ have a higher proportion of late-stage diagnoses. In some cases, however, this is an artifact of the high proportion of cases lacking staging data in this age group. Findings suggest that patients aged 85 and older are disproportionately likely to be either diagnosed while resident in a long-term care facility, or to have a diagnosis of cancer noted only on the death certificate. Both of these factors contribute to the high percentage of “unstaged/unknown stage” cancers in this population, and to the apparent excess of late-stage diagnoses in the “oldest old.”

Learning Objectives:

• Identify patterns of cancer incidence, mortality, and stage at diagnosis in the elderly in Massachusetts.
• Describe differences in incidence, mortality, and stage at diagnosis patterns between the “oldest old” (ages 85+) and other elders (ages 65-84).
• Understand possible reasons for the elevated proportion of late-stage cancer diagnoses in the “oldest old.”

Keywords: Elderly, Cancer

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation