ABSTRACT
Introduction Cancer incidence is expected to increase dramatically in the 21st century. The increase is likely to be driven largely by cancers diagnosed in senior adults. This is particularly true for colorectal cancer (CRC), where approximately 50% of cases are diagnosed in patients older than 70 years of age, with a median age at diagnosis of about 71 years. The relative survival of senior CRC patients is worse than that of younger individuals, possibly because of a more advanced stage at presentation but quite often suboptimal management. Concerns over existing comorbidities, physical or mental frailty, and age-specific deteriorating organ function are often cited as reasons for senior CRC patients not receiving “optimal” treatment. Indeed, senior CRC patients have so far been underrepresented in clinical trials, and therefore, extrapolation of such results to this group of patients can only be made with caution. The data for patients over the age of 75 years appear especially sparse. The difficulties and potential pitfalls in managing senior CRC patients in the adjuvant and advanced disease setting will be considered.
