Geriatric Oncology in Japan

Abstract

The Japanese population is aging rapidly. In 2015, 26% of the population was over 65 years of age. However, clinical trials often underrepresent older patients, and physicians are left to manage the majority of their patient who are older, with very limited evidence. In response to this growing need for more clinical evidence, we organized the Geriatric Study Committee (GSC) within the Japan Clinical Oncology Group with funding from the Agency for Medical Research and Development (AMED) of Japan. The purpose of the GSC group was to (1) define elderly patients in clinical trials; (2) determine the standard tools for geriatric assessment; and (3) establish the methodological schemes for clinical trials of the elderly. We present the geriatric research policy that was developed from the working group. In addition, we used Hospital-Based Cancer Registry data linked DPC (Diagnosis Procedure Combination) administrative claims database fromOctober 1, 2012 to December 31, 2014 of patients diagnosed with lung, gastric, colorectal cancer in 2013 to describe how the distribution of treatment modality (surgery, chemotherapy, radiation therapy, and palliative therapy) for their first course cancer treatment differed by cancer type, stage, and advancing age. We also studied how chemotherapy regimens varied across older age groups. Based on these experiences, we present age-related issues and recent topics in geriatric oncology.