Cancer is mainly a disease of the elderly. As a result of increased life expectancy, over 60% of new cancer cases and over 70% of cancer deaths occur in people 65 years of age or older in Europe and in the US.1 Ageing is associated with progressive but extremely uneven decline of functional reserves and a reduction of adaptability. Geriatricians, who commonly handle the highly heterogeneous process of ageing, have devised a comprehensive multidisciplinary assessment tool called ‘comprehensive geriatric assessment’ (CGA), in which all aspects of older individuals are considered and all resources and abilities are listed. Based on this appraisal, geriatricians can elaborate and co-ordinate an effective care plan with interventions tailored to each individual’s problems.2
Health authorities and health professionals must face the expanding challenge of the management of elderly cancer patients. This challenge has not been anticipated and the ever-increasing number of elderly patients suffering from cancer will result in higher costs of medical and social care. However, the costeffectiveness of cancer management in the elderly remains to be evaluated both at country level, because health organisations are different across European countries,3 and at the European level. Cost-effective strategies for preventing and detecting cancer early should also be considered.4 Two important observations are that elderly patients have been critically undertreated in the past,5 but that their willingness to receive treatment is evident.6
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