Continuing disparities in survival rates between younger and older cancer patients in Europe. Might oral chemotherapy provide one solution to the problem?

摘要

Data released by the United Nations show that Europe is currently the world region with the highest number of older persons relative to its population and is likely to remain so until 2050 at the earliest (United Nations Population Division, 2007). Most of us are familiar with this fact and may already be contemplating the economic and healthcare costs associated with the demographic shift indicated by these figures, particularly as the majority of cancers are positively correlated with increasing physiological senescence in old age (Rubin et al., 2010). It is likely however, that fewer of us are familiar with other data in relation to cancer and the elderly which suggest that in spite of much publicised improvements in cancer prevention, screening and treatment; there is evidence of a growing survival gap between older and younger cancer patients in Europe (Quaglia et al., 2009, 2007; Janssen-Heijnen et al., 2005). This scenario is markedly different from the United States where no such age gap in cancer survival rates appears to exist (Gatta et al., 2000), and we should therefore resist the temptation to believe that such inequalities are the natural sequelae of what has sometimes erroneously been referred to as Europe's 'demographic time bomb' (Mullan, 2002).