Cancer in the elderly: a prospective study among Hawaiian Japanese men

In the United States, little has been done to compare the cancer risk of elderly subjects, aged 65 and older, with that of younger subjects. Although the elderly constitute only 12% of the population, they are diagnosed with more than 50% of the cancers. The study consisted of 7,783 Japanese-American men, born from 1900-1919 and examined from 1965-1968. During 154,000 person-years of follow-up, 1,478 incident cases of cancer were identified. The incidence rate of cancer was high among the elderly (142.7 per 10,000 person-years) compared with younger subjects (48.2 per 10,000 person-years), yielding a significant (p < 0.05) rate ratio of 3.0. Of the site-specific cancers, prostate cancer showed the highest rate ratio of 7.0, followed by oral, stomach, lung, and colon cancer. In addition, the five-year age-specific rates for stomach and colon cancer rose directly with age. A similar pattern was also observed for lung and prostate cancer in men before age 80, but the rates declined thereafter. The findings from this study suggest that the reduction in risk for cancers of the prostate, oral cavity, stomach, lung, and colon must be viewed as a major goal for improving the public health in the elderly population.