Cancer stage-to-age relationship: implications for cancer screening in the elderly

In a study specifically addressing the age-stage relationship, the authors examined the distribution of 30,991 cancers by disease-stage versus patient-age at the time of diagnosis. For cancer of the bladder, breast, cervix, ovary and uterus (endometrium), a highly significant positive relationship was found between advancing stage and advancing age (P less than 0.001). For cancer of the kidney and stomach, the relationship held but was less significant (P less than 0.05). For colorectal cancer, no relationship was evident. For bronchial cancer there was a highly significant inverse relationship (P less than 0.001). After the site of origin of the cancer, the stage at the time of diagnosis was the next most important determinant for treatment and survival. These data emphasize the importance of periodic pelvic examination as a means of screening for asymptomatic cervical, ovarian, or other uterine (endometrial) cancer in elderly women. Also, the data support the importance of breast self-examination and mammography in screening for breast cancer in older women. The inverse relationship of age to stage in bronchial cancer suggests that screening by periodic chest roentgenograms and cytologic sputum examinations may be more appropriate for elderly than for younger populations in whom these screening methods have proved disappointing.