Management of colorectal cancer in older adults: an expert panel recommendation to guide daily clinical practice.

Abstract

Colorectal cancer predominantly affects older adults (ie, those aged 70 years or older). Along with shifting demographic trends, the number of patients with colorectal cancer in this age group is estimated to sharply increase globally over the next few decades. During the past decade, new treatment modalities and systemic therapeutic options have been introduced through well conducted clinical trials that shaped and fundamentally redefined the treatment landscape. However, older adults with reduced physiological reserves, functional impairment, comorbidities, and geriatric syndromes are under-represented in such studies. Yet, for this population, growing evidence for geriatric assessment and management shows patient-centred benefits with the potential to further improve outcomes, parallel to the broadening armamentarium of medical innovations. The purpose of this Review is to summarise the evidence base of the current therapeutic landscape of colorectal cancer and guide management of older adults in daily clinical practice through pragmatic decision making.