ABSTRACT
For 1999, the expected burden of cancer in the United States was estimated to include the diagnosis of 1,221,800 new cases of all types of cancer (1). One of every two men was expected to develop a serious malignancy during his lifetime, and for women, one of every three. Incidence trends from SEER (Surveillance, Epidemiology, and End Results) data up to 1995, and for the 5-year period from 1991 to 1995, indicated that about 60% of expected cancer cases occur in individuals who are 65 years of age or older (2). This group of elderly cancer patients represents a target population for whom interventions might be used to prevent the occurrence of invasive cancer. In opting for the preventive approach, many individuals who might never develop cancer would nevertheless go through the prevention process. The costs of prevention in terms of time, procedures, medications, and side effects, particularly in the segment of the population that would not develop cancer, must be weighed against the burden of the disease in patients who could delay or avoid its occurrence with preventive interventions. Once an older individual is diagnosed with invasive cancer, there is no doubt about the need to consider the therapeutic options; however, at that point, the more aggressive natural history of invasive cancer and the likelihood of comorbid conditions may limit the opportunity for avoiding mortality and morbidity.
