Clinicopathological analysis on cancers of autopsy cases in a geriatric hospital

It is generally accepted that cancers in the elderly are of low grade malignancy. In order to clarify this point, autopsy cases from a medical center for the elderly between 1982 and 1994 were pathologically analyzed. Three hundred and fifty (160 males, 190 females) out of a total of 871 (361 males, 510 females) autopsy cases were examined. The incidence of cancer in various age groups were found to be as follows: < or = 69 years, 24/67 (36%); 70-74 years, 40/102 (39%); 75-79 years, 54/136 (39%); 80-84 years, 79/180 (44%); 85-89 years, 66/172 (38%); 90-94 years, 59/137 (43%); 95-99 years, 17/56 (30%); and > or = 100 years, 12/21 (57%). The incidences did not significantly differ among the groups, that is, there was no age-dependency in the incidence of cancer. Furthermore, the incidences of multiple cancers (two or more different malignancies in one patient) also did not differ. However, deaths due to the cancers showed a tendency to decrease with age. The survival periods of clinical cancer cases without a surgical operation history (time period between the date of diagnosis and death), were age-related for female cases. However, the rate of distant metastasis was not age-related. The incidence of latent cancers in individuals over 85 years of age was 79/174 (45.4%) and significantly higher than the value of 69/234 (29.5%) for those under 85. The number of malignant tumors in various organs for the different age groups was also counted and the total numbers of clinical cancers and latent cancers in each organ were, 50 and 23 in the lung, 46 and 20 in the stomach, 41 and 31 in the colon, 0 and 39 in the prostate, and 14 and 0 in the mammary glands, respectively. All prostate cancers were latent cancers, and all mammary cancers were clinical cancers. These findings provide strong evidence that cancers in individuals of advanced age have less malignancy potential.