Colon cancer in the older population

Abstract

Fifty percent of new diagnoses of colorectal cancer are made in patients aged over 70 years, and 25% are aged 80 years or over. Older patients tend to have locally advanced colon cancer, with negative lymph nodes and without distant metastasis. Frequently the colon cancer is located on the right side. There is still a belief that older patients can not manage curative treatment regimens. This is based on the results of older studies showing higher rates of short-term morbidity and mortality. At present, we are observing significant improvements in the outcomes of older patients with colon cancer in high volume centers. This could be due to better preoperative staging, increased use of minimally invasive techniques, better anesthesiology and perioperative care, awareness of complications, expertise and high-volume care. A standardized pre-operative diagnostic approach, individualized surgical technique selection and tailored postoperative care are essential for the successful treatment of older patients. Furthermore, counseling and shared decision-making should be based on modern insights in surgical outcomes rather than outdated data.

Malignant neoplasm of the sigmoid colon found accidentally during a routine gynecological examination

“…This case shows that regardless of the medical specialty, attention should be paid to changes in other organs, including those that are not directly examined. Most colorectal cancers are diagnosed in older patients, over 70 years of age [1]. This patient was in her 50s at diagnosis, so it can be concluded that one should be vigilant for cancer, even if the patient is not directly in the high-risk age group.…”