Cancer disproportionately affects older adults, with more than 50% of people diagnosed with cancer aged 65 or older. This is in large part due to the fact that risk factors for specific cancers increase and accumulate with age, while the body’s ability to repair itself diminishes.
At the same time, age adds a layer of complexity to cancer diagnosis, treatment and care. Many cancers are diagnosed later, as early symptoms may be mistaken for other minor illnesses; older adults are more likely to have other health concerns (co-morbidities); there may be a stronger desire or need to emphasise quality of life and palliative care rather than treatment; and older patients often face social isolation as well as discrimination in the approach to their care and a lack of knowledge or understanding of their particular needs.
Older adults with cancer require tailored support, from initial assessments to additional support, but research into the treatment and care of older adults with cancer is limited. There is also a global shortage of cancer services for older adults with cancer, with many of the available facilities clustered in high-income countries and urban centres.
There are clear, actionable and feasible interventions that countries can take to improve the quality of care for older adults with cancer, even in low-resourced settings. An important step is to improve awareness of the economic, social and developmental burden countries face with respect to cancer in older adults and what policy responses may be available. The health workforce needs to be strengthened in its geriatric and oncological knowledge even at the primary care level, and care for older adults with cancer should be integrated into National Cancer Control Plans (NCCPs) and Universal Health Coverage strategies. Finally, information should be shared internationally to foster the development of best practice and the needs of older adults included in relevant global, regional and national cancer advocacy.
As populations around the world are ageing at an increasing rate, many governments particularly in low- and middle-income countries have a limited period of time to develop appropriate policy and health system responses, as 80% of older people will be living in low- and middle-income countries by 2050.
For these reasons, UICC has been strengthening its work in the area of cancer and ageing. As part of this work and in collaboration with its partner Sanofi, UICC has awarded grants to five organisations from its Cancer Advocates programme to support advocacy efforts dedicated to addressing gaps in care for older cancer patients at national or regional levels. The grants will cover a duration of work up to 12 months.
The five successful grantees are: ASAPRECAN (El Salvador), National Cancer Council of Mongolia, NGO Avesto (Tajikistan), KENCO (Kenya), and Asociación Guatemalteca Héroes de Esperanza (Guatemala). These organisations will leverage the learning and experience they have gained through the Cancer Advocates programme and build on their respective existing national advocacy strategies to move the dial nationally on issues of cancer and ageing.
Key areas of focus for these organisations include integrating appropriate geriatric oncology services into national health systems, improving the capacity and knowledge of health workers, increasing the availability of palliative care specifically tailored to older patients, and ensuring cost-free access to cancer medicines for patients over the age of 65, to improve their quality of life and chances of survival.
The organisations selected will leverage the strong relationships they have developed with decision-makers in their countries as part of the Cancer Advocates programme. They aim to specifically work on the development of legislation, the updating of NCCPs and advocating for a larger health budget to ensure a more comprehensive approach to care. Other focus areas will be to develop geriatric cancer guidelines and clinical recommendations to build the capacity and knowledge of health workers and improve the quality-of-care services.
The provision of these grants emphasises UICC’s role in supporting its members’ advocacy efforts within their context, as well as UICC’s contribution to improved access to early detection, diagnosis, treatment and palliative care for older patients with cancer around the world.