Appropriate prevention and detection of gastrointestinal neoplasms in the elderly

The incidence of colorectal carcinoma and gastric cancer is related to environmental factors and lifestyle. Long-term exposure to multiple mutagens is believed to initiate the carcinogenesis of colorectal and gastric cancer. Even though patients older than 65 years of age have developed particular modes of cooking and dietary preferences, these habits can be changed with instruction, patient-doctor rapport, and suggestions of alternative foodstuffs that are palatable to them. Elderly patients can be persuaded to avoid fatty foods; smoked, pickled, and salted fish; and red meat. They should be encouraged to eat chicken, fish, fresh fruit, and vegetables (especially cruciferous vegetables), to ingest vitamin C, and to avoid overcooking, frying, and excessive broiling of meat and fish. Surveillance examinations must be practiced in the elderly to avoid malignant conversion of adenomatous polyps. All patients who have undergone gastric resections for peptic ulcer disease need to be watched carefully, with identification of high-risk individuals who must undergo periodic endoscopy.