Adults aged 85 years and older, the “oldest old,” are the fastest‐growing age group in the United States, yet relatively little is known about their cancer burden. Combining data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the National Center for Health Statistics, the authors provide comprehensive information on cancer occurrence in adults aged 85 years and older. In 2019, there will be approximately 140,690 cancer cases diagnosed and 103,250 cancer deaths among the oldest old in the United States. The most common cancers in these individuals (lung, breast, prostate, and colorectum) are the same as those in the general population. Overall cancer incidence rates peaked in the oldest men and women around 1990 and have subsequently declined, with the pace accelerating during the past decade. These trends largely reflect declines in cancers of the prostate and colorectum and, more recently, cancers of the lung among men and the breast among women. We note differences in trends for some cancers in the oldest age group (eg, lung cancer and melanoma) compared with adults aged 65 to 84 years, which reflect elevated risks in the oldest generations. In addition, cancers in the oldest old are often more advanced at diagnosis. For example, breast and colorectal cancers diagnosed in patients aged 85 years and older are about 10% less likely to be diagnosed at a local stage compared with those diagnosed in patients aged 65 to 84 years. Patients with cancer who are aged 85 years and older have the lowest relative survival of any age group, with the largest disparities noted when cancer is diagnosed at advanced stages. They are also less likely to receive surgical treatment for their cancers; only 65% of breast cancer patients aged 85 years and older received surgery compared with 89% of those aged 65 to 84 years. This difference may reflect the complexities of treating older patients, including the presence of multiple comorbidities, functional declines, and cognitive impairment, as well as competing mortality risks and undertreatment. More research on cancer in the oldest Americans is needed to improve outcomes and anticipate the complex health care needs of this rapidly growing population.

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2019 年 85 岁及以上成年人的癌症统计数据

85 岁及以上的成年人，即“最年长的老人”，是美国增长最快的年龄组，但对他们的癌症负担知之甚少。结合来自国家癌症研究所、北美中央癌症登记协会和国家卫生统计中心的数据，作者提供了有关 85 岁及以上成年人癌症发生的全面信息。2019 年，美国最年长的老人中将有大约 140,690 例癌症确诊病例和 103,250 例癌症死亡病例。这些个体（肺癌、乳腺癌、前列腺癌和结肠直肠癌）中最常见的癌症与一般人群中的癌症相同。总体癌症发病率在 1990 年左右在最年长的男性和女性中达到顶峰，随后下降，在过去十年中这一速度加快。这些趋势在很大程度上反映了前列腺癌和结肠直肠癌的减少，以及最近男性肺癌和女性乳腺癌的减少。我们注意到与 65 至 84 岁的成年人相比，最老年龄组的某些癌症（例如肺癌和黑色素瘤）的趋势存在差异，这反映了最老几代人的风险升高。此外，年龄最大的癌症在诊断时通常更先进。例如，与在 65 至 84 岁患者中诊断出的乳腺癌和结直肠癌相比，在 85 岁及以上患者中诊断出的乳腺癌和结直肠癌在局部阶段被诊断出的可能性大约低 10%。85 岁及以上的癌症患者在所有年龄组中的相对存活率最低，当癌症在晚期被诊断出时差异最大。他们也不太可能因癌症接受手术治疗；85 岁及以上的乳腺癌患者中只有 65% 接受了手术，而 65 至 84 岁的患者中这一比例为 89%。这种差异可能反映了治疗老年患者的复杂性，包括存在多种合并症、功能下降和认知障碍，以及相互竞争的死亡风险和治疗不足。需要对最年长的美国人的癌症进行更多研究，以改善结果并预测这个快速增长的人口的复杂医疗保健需求。包括多种合并症、功能下降和认知障碍的存在，以及相互竞争的死亡风险和治疗不足。需要对最年长的美国人的癌症进行更多研究，以改善结果并预测这个快速增长的人口的复杂医疗保健需求。包括多种合并症、功能下降和认知障碍的存在，以及相互竞争的死亡风险和治疗不足。需要对最年长的美国人的癌症进行更多研究，以改善结果并预测这个快速增长的人口的复杂医疗保健需求。