Gynecologic Malignancies in the Elderly

Abstract

Gynecologic malignancies are a significant health problem for elderly women. If discovered in their early stages, each of these cancers is curable, but increasing age usually correlates with more advanced stage of disease at presentation. In addition, elderly women are often more difficult to treat as a consequence of a higher incidence of intercurrent medical illness. Except of endometrial cancer, however, age alone has not been found to be of prognostic significance when other factors such as stages nodal involvement are controlled for. Endometrial, vulvar, and cervical cancer can all be discovered in asymptomatic women by scrrening procedures. These inculde simple inspection, speculum examination, cervical cytologic examination for cervical cancer, vaginal cytologic examination for endometrial cancer (vaginal pool smear), and, in high-risk groups, endometrial sampling (cytologic or histologic). Ovarian cancer is difficult to detect at an early stage, but thorough pelvic examination can detect adnexal masses. The burden of discovering these illnesses at early stage must fall on the primary care giver, as few elderly women are under gynecologic care.