Age
cutoffs
clinical oncology guide
biomarkerslines
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Are the chronological age cutoffs used in clinical oncology guidelines biologically meaningful?
Summary
- Age is a significant risk factor for cancer, influencing tumour biology, treatment recommendations, and therapy response.
- Breast cancer incidence peaks around 70 years of age, with over one-third of diagnoses in this age group.
- Clinical guidelines vary in defining "older" patients, using age cutoffs like 65 and 70 years, leading to inconsistency.
- Historical and societal factors, such as retirement age, influenced these age cutoffs rather than biological relevance.
- The aging process is dynamic and varies among individuals, complicating the use of chronological age as a sole factor in guidelines.
- There is ongoing research to identify biomarkers of aging that could provide a more accurate basis for clinical guidelines.
- Clinical trial enrollment often under-represents older patients, and varying age cutoffs in trials further complicate standardization.
- Proposed shift to using frailty-based instead of chronological age cutoffs in guidelines to better reflect patient health status.
- Efforts to standardize age definitions and integrate biological, clinical, and chronological criteria are needed to improve guidelines.
Cancer is predominantly a disease of ageing: the incidence of many epithelial tumours increases with age. With a peak incidence at around 70 years of age, breast cancer is no exception. Moreover, more than one-third of all breast tumours are diagnosed in patients over this age. In older patients with breast cancer, the biology of the disease has a more indolent phenotype that reflects an enrichment of hormone receptor-positive tumours, a phenomenon that has been recognized for decades. A question that remains to be answered, however, is whether this transition occurs at a discrete age or whether breast cancer biology changes gradually with age after menopause.....
Age, cutoffs, clinical oncology guide, biomarkers