Population of elderly patients with cancer – a growing public health problem in the perspective of national health programmes in Poland

Abstract

We are witnessing an unprecedented increase in the population of elderly people in Poland and other countries. A large number of these people are at risk of falling ill with cancer. In recent years, medicine has successfully reduced mortality from cardiovascular diseases. Unfortunately, it has been impossible to achieve a significant reduction in cancer mortality, especially in countries with a medium-high human development index, including Poland. The mortality of elderly people due to cancer is particularly difficult to reduce. Screening programmes should be targeted primarily at the older people. The number of people who are unnecessarily tested to diagnose one case of cancer is the lowest in this population. However, screening methods are nonspecific, result in cancer overdiagnosis, extend the lead time, but do not reduce mortality. New screening methods that identify the highest-risk conditions should be developed primarily for the use in the older population. Survivorship care plans for patients who have had cancer are equally important for elderly and younger people. They allow younger patients to resume active life and work. In the elder, they may facilitate control of comorbidities likely to exacerbate after cancer treatment. These exacerbations increase the costs of hospital treatment, reduce the quality of life and increase mortality for reasons not directly related to cancer. The higher cancer mortality rate in elderly patients is partly associated with the fact that treatments with proven effectiveness in younger patients are not used in elderly people because there is no evidence for their clinical benefit but also because they may be overtreated. Relevant studies are currently being carried out by specialized institutions. These challenges should be considered in the debates on the priorities of updated versions of the National Cancer Control Programme and the National Health Programme.