Bingöl ilinde yaşayan yaşlı bireylerde kanser insidansı ve sağkalım analizi

Amaç: Kanser ülkemizde ve dünyada önemli bir halk sağlığı sorunudur. Bu çalışma ile yaşlı nüfusta kanser vakalarının yıllara göre insidansının hesaplanması, değişim yönünün değerlendirilmesi ve kanser türlerinin yaşlı nüfustaki dağılımı ve sağkalım üstünde etkisinin incelenmesi amaçlanmıştır.Gereç ve Yöntem: Çalışma 2019 yılında yapılmıştır. Çalışma 2013-2016 yılları arasında 65 yaş üstü 596 kanser hastasının verileri üstünde yapılmıştır. Verilerin analizinde Pearson Ki-kare testi, Cox regresyon analizi ve Kaplan-Meier yaşam analizi kullanılmıştır.Bulgular: Hastaların %66,1’i (394) erkek, %33,9’u (202) kadındır, yaş ortalaması 74’dür. Hastaların %47,7’si (284) takip süresi içinde ölmüştür. Kanserlerin en çok köken aldığı doku sindirim sistemi 200 (%33,6), takip süresi içinde ölümün en çok görüldüğü kanser türü solunum sistemi 44 (%59,5 kanserleridir. Kanser insidansı çalışma süresi boyunca artış trendindedir. Cerrahi tedavinin sağkalım süresine anlamlı olarak katkı yaptığı, ölüm riskini 2,8 kat azalttığı bulunmuştur. Kemoterapi tedavisinin de ölüm riskini 1,2 kat azalttığı bulunmuştur.Sonuç: Yaşlılarda kanser insidansı artmaktadır. Yaşlılarda en çok sindirim sistemi kanserleri görülürken, ölümün en fazla olduğu kanser türü solunum sistemi kanserleridir. Yaşlılarda kanser taramalarının etkin biçimde yapılması ve sağlıklı yaşlanma stratejilerinin yaygınlaştırılması önerilebilir.

Anahtar Kelimeler:

elderly, survival analysis, incidence, cancer

Cancer incidence and survival analysis among elderly people in Bingol province

Purpose: Cancer is an important public health problem in Turkey and in the world. The aim of this study was to determine the incidence of cancer in the elderly population over the years, to evaluate the direction of change in cancer incidence, and to investigate the distribution of cancer types in the elderly population and their effect on survival.Materials and Methods: This study was conducted in 2019. The study was conducted on the data of 596 cancer patients over 65 years of age collected between 2013 and 2016. Pearson’s chi-square test, Cox regression analysis, and Kaplan-Meier survival analysis were used for data analysis.Results: The mean age of the patients was 74 years. (394) 66.1% of the patients were male and (202) 33.9% were female. 47.7% (284) of the patients died during the follow-up period. Cancers were most commonly originated from the gastrointestinal tract. Respiratory cancers had the highest rate of mortality during the follow-up period. Cancer incidence had an increasing trend during the follow-up period. It was found that surgical treatment significantly contributed to survival and reduced mortality risk by 2.8 fold. Chemotherapy was also found to reduce mortality risk by 1.2 fold.Conclusion: The incidence of cancer is increasing in the elderly population. Gastrointestinal cancers are the most common cancers in the elderly population, but the highest rate of mortality is observed in respiratory cancers. It can be recommended that cancer screening should be effectively performed and disseminating healthy aging strategies in the elderly population.

Keywords:

Elderly, survival analysis, cancer,

PDF

___

1. Stewart BW, Wild CP. World Cancer Report. Lyon, WHO, 2014..
2. World Health Organization. Global Health Observatory. Geneva: World Health Organization; 2018.
3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394-424.
4. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7-30.
5. Türkyılmaz M, Hacıkamiloğlu E, Baran Deniz E, Boztaş G, Dündar S, Kavak Ergün A. Cancer Statistics in Turkey 2015. Ankara, Turkish Organization for Public Health, 2015..
6. Rao AV, Seo PH, Cohen HJ. Geriatric assessment and comorbidity. Semin Oncol. 2004;2:149-59.
7. Dale DC. Poor prognosis in elderly patients with cancer: the role of bias and undertreatment. J Support Oncol. 2003;1:11-7.
8. Anisimov VN. The relationship between aging and carcinogenesis: a critical appraisal. Crit Rev Oncol Hematol. 2003;45:277-304.
9. Zeng C, Wen W, Morgans AK, Pao W, Shu XO, Zheng W. Disparities by race, age, and sex in the improvement of survival for major cancers: results from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program in the United States, 1990 to 2010. JAMA Oncol. 2015;1:88-96.
10. Aberle DR, Berg CD, Black WC. National lung screening trial. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409.
11. Davidoff AJ, Tang M, Seal B, Edelman MJ. Chemotherapy and survival benefit in elderly patients with advanced non–small-cell lung cancer. J Clin Oncol. 2010;28:2191-7.
12. Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017;49:292-305.
13. Lee JH, Wu HG, Kim HJ, Kim DW, Lee SH, Kim TM et al. Influence of comorbidities on the efficacy of radiotherapy with or without chemotherapy in elderly stage III non-small cell lung cancer patients. Cancer Res Treat. 2012;44:242-50.
14. Wong YN, Mitra N, Hudes G, Localio R, Schwartz JS, Wan F, et al. Survival associated with treatment vs observation of localized prostate cancer in elderly men. JAMA. 2006;296:2683-93.
15. Bill-Axelson A, Holmberg L, Ruutu M, Garmo H, Stark JR, Busch C et al. A. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med. 2011;364:1708-17.
16. Sundararajan V, Mitra N, Jacobson JS, Grann VR, Heitjan DF, Neugut AI. Survival associated with 5- fluorouracil–based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Intern Med. 2002;136:349-57.
17. Bergman L, Kluck HM, Van Leeuwen FE, Crommelin MA, Dekker G, Hart AA et al. The influence of age on treatment choice and survival of elderly breast cancer patients in south-eastern Netherlands: a population-based study. Eur J Cancer. 1992;28:1475- 80.
18. Rutten H, den Dulk M, Lemmens V, Nieuwenhuijzen G, Krijnen P, Jansen-Landheer M et al. Survival of elderly rectal cancer patients not improved: analysis of population based data on the impact of TME surgery. Eur J Cancer. 2007;43:2295-300.
19. Vercelli M, Capocaccia R, Quaglia A, Casella C, Puppo A, Coebergh JW et al. Relative survival in elderly European cancer patients: evidence for health care inequalities. Crit Rev Oncol Hematol. 2000;35:161-79.
20. Mery CM, Pappas AN, Bueno R, Colson YL, Linden P, Sugarbaker DJ et al. Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest. 2005;128:237-45.