Changes in Cancer Care for Patients Aged 80 and Above: A Cohort Study from Samsung Comprehensive Cancer Center in South Korea

초록

Background/Objectives: With an estimated 70% of new cancer diagnoses expected to be in older adults within the next decade, cancer care for this population has attracted increasing global attention. Additionally, older patients are less likely to receive optimal cancer treatments. Methods: This retrospective cohort study utilized data from the Samsung Medical Center Cancer Registry, which includes patients diagnosed with cancer between 2008 and 2022. A 15-year cohort analysis was conducted to examine trends and survival outcomes by cancer type and stage in patients aged 80 years and older. Results: Among 301,055 patients with cancer, 13,111 (4.4%) were aged 80 years or older at diagnosis. The proportion of patients in this age group increased from 2.4% in 2008 to 5.8% in 2022. The most prevalent cancers in patients aged >= 80 years were lung (18.9%), stomach (15.3%), and colorectal cancer (13.8%). Among individuals with localized or regional-stage disease, the 5-year survival rate was 49.66% in those aged >= 80 years compared to 81.46% in younger patients (HR = 1.41; 95% CI = 1.35, 1.46). For distant-stage disease, survival was lower, at 10.53% in patients aged >= 80 years versus 27.61% in those aged <80 (HR = 1.14; 95% CI = 1.10, 1.19). Among patients aged 80 years and older, 55% received anti-cancer treatment, with the proportion increasing from 54.5% in 2008 to 60.3% in 2021. This increase was particularly notable in individuals with distant-stage disease. Additionally, the proportion of clinical trial participants aged >= 80 years exhibited an upward trend. Patients in this age group who underwent treatment had significantly improved survival compared to those who did not, in both localized or regional disease (HR = 0.45; 95% CI = 0.42, 0.49) and distant disease (HR = 0.58; 95% CI = 0.53, 0.62). Conclusions: The findings from this cohort of the SMC Cancer Registry highlight key trends, including a rising number of patients aged >= 80 years and an increasing proportion receiving treatment, particularly after 2020, when more than 60% received therapy. Furthermore, survival benefits associated with treatment were comparable to those observed in younger patients across all cancer types.

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