With cancer death rates highest among people 65 years and older, the National Cancer Institute (NCI) and the National Institute on Aging (NIA), both parts of the National Institutes of Health (NIH), are launching a new initiative to accelerate research into the relationship between aging and cancer. The 5-year approximately $25 million grant program will begin with $5 million in first-year grants to eight research centers.

Aging and cancer researchers identified specific research goals at a joint NIA/NCI workshop, Exploring the Role of Cancer Centers for Integrating Aging and Cancer Research (www.nia.nih.gov/health/nianci/), in June 2001. Workshop participants noted that people 65 years or older are at the highest risk for cancer compared to those less than 65 years of age. For all cancers combined, people 65 years or older have an incidence rate 10 times greater than the rate for younger people. The mortality rate for older cancer patients is 16 times greater than the rate for younger patients. The need for research at the aging/cancer interface has never been more urgent, as the number of individuals in the 65 years and older age segment of the U.S. population is expected to double from 35 million to 70 million by 2030.  

"Cancer is a disease of aging and is increasing in magnitude as people live longer. Ending the suffering and death due to cancer by 2015 requires us to understand the behavior of cancer, responses to therapy, and the after-effects that are unique to the older patient," said NCI Director Andrew C. von Eschenbach, M.D.

"We must close the significant knowledge gap on cancer and aging," said NIA Director Richard J. Hodes, M.D. "We need research that tells us why cancer is more prominent in older people, whether cancer behaves differently in the young and the old, and whether the treatment should be different for the different age groups."

Research for the initiative was selected from among seven areas identified at the NIA/NCI workshop that included:

1.  Patterns of Care -- Research into the effects of comorbidity as it relates to treatment. This might include community-based studies, patient management, and cancer site-specific studies.

2.  Treatment Efficacy and Tolerance -- Research into older people's absorption, distribution, metabolism, and excretion of drugs, including response to drugs and radiation.

3.  Effects of Comorbidity -- Developing optimum ways to characterize, before cancer treatment, the nature, severity, and likely effects of co-morbidities in order to offset and reduce any harmful impact of a patients' other health problems on their cancer treatment.

4.  Prevention, Risk Assessment, and Screening -- Research on whether age biases in the health care system interfere with the delivery of effective, optimal prevention and early detection services.

5.  Psychosocial Issues and Medical Effects -- Developing a core set of tools to assess the quality of life of older cancer patients, ways to reduce caregiver and care recipient stress, and interventions to prevent or reduce the medical and psychological effects of cancer treatment.

6.  Palliative Care, End-of-Life Care, Pain Relief -- Research to determine how to ensure that quality cancer care and treatment, including pain management, provides comfort and reflects patient and family preferences.

7.  The Biology of Aging and Cancer -- Research on genetics, molecular signatures, bench to bedside application, translational research, and age-related changes as they contribute to mortality. Research is also needed on older people who are vulnerable to cancer as contrasted with those who are not.

More information on integrating aging and cancer research can be found in the workshop report issued in 2002 at http://nia.nih.gov/health/nianci/.  Details on the grants for Aging and Cancer follow: