Increasing trends in some cancers in older Americans: fact or artifact?

Area of Science:

• Epidemiology
• Oncology
• Public Health

Background:

• Doll and Peto hypothesized that rising cancer mortality in older adults (over 64) from 1933-1978 was due to misattribution of deaths to ill-defined causes.
• Previous analyses suggested artifactual increases in mortality data for the elderly.

Purpose of the Study:

• To test the hypothesis that increased cancer mortality in older adults is an artifact.
• To examine age-specific and cause-specific mortality trends in individuals aged 35-84 during 1968-1978.

Main Methods:

• Analysis of U.S. cancer mortality data using the 8th International Classification of Diseases, Adapted (8-ICDA) for the period 1968-1978.
• Focus on age-specific and cause-specific mortality trends in individuals aged 35 to 84.
• Comparison of trends in specific cancers (lung, brain, multiple myeloma) with potentially miscoded causes of death.

Main Results:

• Observed increasing trends in mortality from lung cancer, brain cancer, and multiple myeloma in older white and nonwhite populations (ages 35-84) from 1968 to 1978.
• Concurrent increases in mortality from several potentially miscoded causes of death were noted during the same period.
• The data suggest that the observed increases in these specific cancers among the elderly are not entirely explained by misattribution.

Conclusions:

• The rising cancer mortality trends in the elderly cannot be solely attributed to artifacts or miscoding.
• Further research on site-specific cancer mortality trends should extend to age groups up to 85 and beyond.
• Continuous monitoring of cancer mortality patterns, especially in the elderly, is vital for effective cancer prevention strategies.