Ovarian, uterine, and cervical cancer in the elderly woman

Older women are at a significantly increased risk of developing ovarian, endometrial, and cervical cancers. When an elderly woman develops one of these malignancies, she is more likely to die from it than a younger woman. The increased mortality-to-incidence ratio may be related primarily to the more advanced stage at diagnosis. Data suggest that elderly women in the United States are less likely to undergo routine gynecologic screening examinations than younger women, which often results in malignancies that are diagnosed at a more advanced stage. More aggressive screening programs directed at elderly women would likely result in an improvement of morbidity and mortality. Treatment modalities for the gynecologic malignancies presented include surgery, radiotherapy, and chemotherapy and must be carefully selected, planned, and sometimes modified for the elderly woman with intercurrent medical problems. There is no evidence that radical pelvic surgery is associated with increased morbidity in most elderly women compared with younger women. Treatment options such as radiotherapy may be associated with significant morbidity for elderly women. Most chemotherapeutic regimens are tolerated by elderly women, but modification of dose or agent may be necessary in selected cases. Improved screening and better treatments for gynecologic malignancies are needed for our nation's aging population. Studies specifically directed at the diagnosis, care, and treatment of elderly patients with gynecologic malignancies are necessary to improve the significant morbidity and mortality associated with ovarian, endometrial, and cervical cancers in elderly women.