The Prevalence of Psychological and Psychiatric Sequelae of Cancer in the Elderly – How Much Do We Know?

Abstract

Introduction: Ageing is the greatest single risk factor for cancer but there is a dearth of systematically reviewed data on the psychological and psychiatric sequelae in elderly cancer patients. The aim of this paper is to review the current literature on these issues. Materials and Methods: Multiple searches using Medline (1970 to 2003), PsycInfo (1970 to 2003), CINAHL (1982 to 2003), EMBASE Psychiatry (1992 to 2003) and Cochrane Research Database were carried out. Additional searches were made using the reference lists of published papers and chapters. Results: Most of the studies were cross-sectional in nature. The few longitudinal studies had fairly short follow-up periods. Overall, the available evidence suggests that up to a third of elderly cancer patients may experience psychological distress. The psychological impact of cancer on the elderly was less adverse or similar compared with younger patients. There were only limited studies that specifically addressed the prevalence of psychiatric disorders in elderly cancer patients, which suggested that the prevalence for clinically significant depression could range from 3% to 25%. Organic mental disorders were more prevalent in the older group. Conclusions: This review suggests that the psychological impact of cancer is less negative in the elderly compared to younger patients. As for the prevalence of psychiatric disorders in elderly cancer patients, this review suggests that it is an unanswered question with a dearth of published data, with most work either based only on clinical or hospital samples or not solely on the elderly.