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to 1101.6. The incidence of breast cancer, the most diagnosed

cancer in females, is estimated to increase from 157.2 to 570.1,

from 104.8 to 773.8, and from 71.7 to 601.2 in aged groups 65–

69, 70–74, 75 and above. The second most frequent type, colon

cancer, had his incidence increase in individuals aged 74 and

below, while it decreased in patients aged 75 and above. Lung

cancer followed with a decrease in incidence rates in the

subgroup 65–69, and an increase in individuals aged 70 and



As the Lebanese population ages, the inci-

dence of cancer increases mainly in individuals aged between

65 and 74 years. The stability observed in patients aged

75 years and above could be the result of a higher mortality

rate or a less frequent disease at this advanced age. Adapted

and personalized therapeutic strategies are needed in the

management of elderly patients; as well as the need for the

establishment of new guidelines in managing this more frail


Disclosure of interest:

None declared



Susan Knox

Europa Donna -The European Breast Cancer Coalition, Milan, Italy

There are many myths and preconceived notions regarding

breast cancer treatment for older women. Decisions about

breast cancer treatment, care, and even screening should

never be based on chronological age alone. I have experienced

breast cancer as a relatively young woman and as an older

one; I will provide some personal insight on how age impacts

decision making and living with breast cancer. Patients want

to get all the information appropriate to their individual

situations and make decisions about treatment together with

health care professionals based on both the facts and their own

personal preferences and life situation. This is fundamental

and is not age dependent. If age needs to be considered, it

is the patient who should decide what option she wishes to

pursue based on the evidence presented eg. inconvenience of

radiotherapy vs mastectomy. It is the patient who needs to

evaluate how much benefit is derived from more aggressive

treatment when one is older vs better quality of life in later

years. One size does not fit all.

Europa Donna—The European Breast Cancer Coalition

advocates that all women should have access to appropriate

screening, treatment, follow up, and access to clinical trials

regardless of age. Age may play a role in treatment decisions

but must be shared between the patient and her health care


Disclosure of interest:

None declared



Ludmila Koch

Department of Medical Oncology, Sao Paulo, Brazil

In less developed countries, the fact that a higher fraction

of patients die from cancer demonstrates that their attempts

to control cancer are much less effective – which is hardly

surprising, given the remarkable disparities in resources

between the lowest and highest income countries. While the

number of elderly will double worldwide by the year 2050, it

will almost triple in Brazil. While in European countries the

aging process took place slowly and only after an enrichment

of nations, in which infrastructure problems were already

solved, the same did not occur here: the aging of the

population is a major challenge for all of us, because we live in

a country where we still have many structural problems to be

solved, such as the public health system, which is insufficient,

basic education of low quality. And this is reflected in the

quality of life of the elderly. According Kalache, the growth

of the elderly population presents a new challenge to health

systems and social support networks in many less developed

countries where populations are becoming old before they

become wealthy. Alliance for Aging Research published in

2002, it is estimated that to care the 35 million Americans

older existing at the time it would take 20,000 geriatricians in

the country, which would amount to a geriatrician / inhabitant

ratio old 1:5,700. In 2015, Brazil has a population aged 60 and

over stands at 25 million and using as given the number of

members of the Brazilian Society of Geriatric and Gerontology,

we can assume that the ratio of geriatricians/elderly is 1/9,900.

While the number of oncologists/inhabitant is 1,7/100,000.

In summary, most less developed countries cannot afford

to develop multidisciplinary geriatric oncology approach.

Special provisions will have to be made in the existing health

system in order to train primary care professionals in the

field of geriatrics. Session will review those topics describing

issues in geriatric oncology in Latin America.

Disclosure of interest:

None declared



Ludmila Koch

Department of Medical Oncology, Sao Paulo, Brazil

Developing countries are in epidemiological and demo-

graphical transition. By 2020, 70% of all cancers will be in

developing countries. By 2050, majority of Geriatric people and

patients will be living in developing countries. Demographic

aging in less developed countries is very much influenced by

the previous explosive demographic growth. Furthermore,

the growth of the elderly in these countries’ populations

happens in a context of poverty, large heterogeneity, and

profound inequity. Between the years 2020 and 2040, these

countries will show age structures approaching that of