What is the prevalence of lung cancer in males over 80 years of age in Canada?

From the Guidelines

The prevalence of lung cancer in Canadian men above age 80 is approximately 477 cases per 100,000 men in this age group, as estimated in North America 1. This represents one of the highest age-specific incidence rates for lung cancer in the Canadian population, with men in this advanced age bracket facing significantly elevated risk compared to younger age groups. The high prevalence reflects the cumulative lifetime exposure to risk factors, particularly smoking, with many cases representing the outcome of tobacco use initiated decades earlier. The latency period between exposure to carcinogens and clinical manifestation of lung cancer often spans 20-30 years, explaining why rates peak in older age groups. Additionally, age-related decline in DNA repair mechanisms and immune surveillance contributes to higher cancer susceptibility in elderly men. Despite improvements in early detection through low-dose CT screening programs, many lung cancers in this population are diagnosed at advanced stages, contributing to poorer outcomes. The prevalence data underscores the importance of smoking cessation at any age and appropriate cancer screening for high-risk elderly individuals. Some studies have reported that approximately 30% to 35% of candidates for lung resection for lung cancer are over 70 years of age 1, and the use of stereotactic ablative radiation therapy (SABR) is increasingly being proposed for inoperable patients 1. However, the treatment of non-small-cell lung cancer in an elderly population should be based on a comprehensive geriatric assessment (CGA) that estimates a patient’s functional status, the presence of comorbidities, mental status and emotional conditions, nutritional status, polypharmacy, and the presence or absence of geriatric syndromes 1. The management of elderly patients with NSCLC should be individualized, taking into account the patient's age, performance status, and comorbidities, as well as the stage and histology of the tumor 1. Overall, the high prevalence of lung cancer in Canadian men above age 80 highlights the need for continued efforts to prevent and detect lung cancer in this population, as well as to develop effective treatment strategies that take into account the unique needs and characteristics of elderly patients. Key factors to consider in the management of lung cancer in elderly patients include:

• The importance of smoking cessation at any age
• The need for appropriate cancer screening for high-risk elderly individuals
• The use of comprehensive geriatric assessment (CGA) to estimate a patient’s functional status and presence of comorbidities
• The individualization of treatment based on the patient's age, performance status, and comorbidities, as well as the stage and histology of the tumor.

From the Research

Lung Cancer Prevalence in Males over 80 Years of Age in Canada

• The provided studies do not directly report the prevalence of lung cancer in males over 80 years of age in Canada 2, 3, 4, 5, 6.
• However, study 2 reports that lung cancer incidence has decreased among males aged 35 or above, with the largest decreases occurring among those 65 or above.
• Study 4 reports that the incidence of lung cancer has decreased among men, with significant decreases in the incidence of lung cancer among men aged 65 or above 4.
• Study 5 reports that the crude incidence rate for men decreased significantly over time in Canada from 1992 to 2010, but does not provide specific data for men over 80 years of age 5.
• Study 6 provides projections of lung cancer incidence in Canada up to 2042, but does not provide specific data for men over 80 years of age 6.
• Study 3 reports that the average age of diagnosis of lung cancer is 70 years old, but does not provide specific data for men over 80 years of age 3.

Age-Specific Lung Cancer Incidence Trends

• Study 2 reports that lung cancer incidence data from 1992 to 2022 by sex and age were obtained from Statistics Canada, and that the study analyzed age-specific lung cancer incidence trends in Canada from 1992 to 2022 2.
• The study found that lung cancer incidence has decreased among males aged 35 or above, with the largest decreases occurring among those 65 or above 2.
• Study 4 reports that the study analyzed age- and sex-standardized incidence trends in Canada for 16 major cancer sites and all cancers combined, and found that the incidence of lung cancer has decreased among men aged 65 or above 4.

Limitations of Available Data

• The available studies do not provide direct evidence on the prevalence of lung cancer in males over 80 years of age in Canada 2, 3, 4, 5, 6.
• The studies provide some information on age-specific lung cancer incidence trends in Canada, but do not provide specific data for men over 80 years of age 2, 4, 5, 6.