chapter  13
22 Pages

Colorectal Cancer in the Elderly

WithPeter C. Enzinger

Colorectal cancer accounts for approximately 10% of all new cancer cases and 10% of all cancer-related deaths in the United States (1). In fact, colorectal cancer causes more deaths than prostate cancer in men aged 60 to 79, and more deaths than breast cancer in women aged 80 years or older (1). Approximately 105,000 new cases of colon cancer and 40,000 new cases of rectal cancer are diagnosed in the United States every year (1). The probability of developing colorectal cancer increases from 0.06% in the first four decades of life to 3% to 4% in the sixth and seventh decades (1). The incidence of colorectal cancer increases from 18 cases per 100,000 persons under the age of 65, to 208 cases per 100,000 persons 65 to 74 years, to 348 cases per 100,000 persons aged 75 years or older (Fig. 1) (2). Similarly, the mortality rate increases from six cases per 100,000 persons under age 65, to 73 cases per 100,000 persons aged 65 to 74 years, to 164 cases per 100,000 persons aged 75 years or older (Fig. 2) (2). Although the five-year relative survival with this cancer is identical for persons under the age of 65 and for persons aged 65 to 74 years (66%), it declines to 60% for individuals aged 75 years or older (Fig. 3) (2). Thus, because of the increasing incidence and decreasing survival with advancing age, the great majority (83%) of the annual 57,000 colorectal cancer deaths will occur in men and women older than age 60 (1).