Integrating geriatric oncology in public health planning

Abstract

If more than 30% of cancers occur at present in France among elderly people, it is estimated that this proportion will reach 50-60% within the next two or three decades. To deal with and anticipate this challenge, successive national Cancer Control Plans have included specific actions on the organization of the treatment of elderly cancer patients. The organizational framework is based on an oncologist-geriatrician partnership at the head of oncogeriatrics coordination units. After a pilot phase conducted in 15 health-care institutions, it has been deployed in 22 regions of mainland France and in one overseas territory. These units are mainly intended to ensure that patients receive cancer treatment suitable for their overall health and age. This organization evolves with both the evolution of the health landscape (in accordance with the modernization law of the health system of 26 January 2016) and the territorial reform that identifies 13 regions in mainland France and five regions in overseas. It also has to take into account not only the therapeutic initial decision but also the patients pathway and their quality of life during and after the cancer treatment. The ability to adapt is essential to fully optimize the treatment of these elderly people suffering from cancer who will shortly represent the vast majority of people with cancer.