Colorectal Cancer in Older Adults

Colorectal cancer is the third most commonly diagnosed cancer worldwide and the second leading cause of death among all malignancies. Despite advances in colorectal cancer screening, the number of deaths has increased. Given that the incidence of colorectal cancer increases with age, it’s important to tailor treatment to this population with special needs. Here we discuss how to incorporate frailty, rather than age, to assess perioperative outcomes. To this end, several useful scoring systems that can easily be incorporated into general practice have been developed. In addition, chemotherapy risk calculators such as CARG or G8 can help predict the likelihood of chemotherapy toxicity in older patients. Focused geriatric assessment in patients with colorectal cancer is associated with improved outcomes such as a decrease in the incidence of chemotherapy toxicity and decreased risk of falls. Overall, geriatricians are an important part of the oncological treatment course and can advocate for their patients to receive tailored treatments to their functional status rather than their age alone.