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Review
. 2022 May 1;128(9):1730-1737.
doi: 10.1002/cncr.34143. Epub 2022 Feb 23.

New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control

Lindsay C Kobayashi  1   2 , Ashly C Westrick  1 , Aalap Doshi  3 , Katrina R Ellis  2   4 , Carly R Jones  4 , Elizabeth LaPensee  3 , Alison M Mondul  1   2 , Megan A Mullins  2   5 , Lauren P Wallner  1   2   6
Affiliations
Review

New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control

Lindsay C Kobayashi et al. Cancer. .

Abstract

Background: The global population of older cancer survivors is growing. However, the intersections of aging-related health risks across the cancer control continuum are poorly understood, limiting the integration of aging into cancer control research and practice. The objective of this study was to review the state of science and provide future directions to improve the quality of evidence in 6 priority research areas in cancer and aging.

Methods: The authors identified priority research areas in cancer and aging through an evidence-based Research Jam process involving 32 investigators and trainees from multiple disciplines and research centers in aging and cancer; then, they conducted a narrative review of the state of the science and future directions to improve the quality of evidence in these research areas. Priority research areas were defined as those in which gaps in scientific evidence or clinical practice limit the health and well-being of older adults with cancer.

Results: Six priority research areas were identified: cognitive and physical functional outcomes of older cancer survivors, sampling issues in studies of older cancer survivors, risk and resilience across the lifespan, caregiver support and well-being, quality of care for older patients with cancer, and health disparities. Evidence in these areas could be improved through the incorporation of bias reduction techniques into longitudinal studies of older cancer survivors, novel data linkage, and improved representation of older adults in cancer research.

Conclusions: The priority research areas and methodologies identified here may be used to guide interdisciplinary research and improve the quality of evidence on cancer and aging.

Keywords: aging; caregiving; cognitive function; health disparities; interdisciplinary research; life course; methodology; physical function; sampling.

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Conflict of interest statement

Katrina R. Ellis reports honoraria from the University of Michigan School of Social Work (the Winkleman Lecture) and service on the Professional Advisory Board of the Cancer Support Community of Ann Arbor (nonpaid) outside the submitted work. Lauren P. Wallner reports an American Cancer Society Research Scholar Grant (ACS RSG‐19‐015) and service on the Data Safety and Monitoring Board as Chair for the EPICS Study (National Cancer Institute R01CA249419) outside the submitted work. The remaining authors made no disclosures.

Figures

Figure 1
Figure 1
Selective survival bias is illustrated using education as an example of a factor that could bias a hypothesized relation between cancer and subsequent cognitive function (indicated by the dashed arrow with a question mark above it). The box around survival indicates that research studies are restricted to individuals who survive to the time of study enrollment, whether they are cancer survivors or cancer‐free controls as a comparison group. The minus (−) and plus (+) signs next to the solid black arrows indicate known relations with negative and positive directions, respectively. A spurious observed relation between cancer and subsequent cognitive functioning could be induced through the back‐door path opened by the 3 causal paths (indicated by the solid black arrows) because the study sample was restricted to survivors.
See this image and copyright information in PMC

Comment in

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