Does (or should) chronologic age influence the choice of cancer treatment?

With rare exceptions, age alone should not determine the diagnostic and therapeutic plan for the management of cancer. Unfortunately, a number of studies show that older individuals have more advanced stages of certain cancers than younger persons, and that this is probably the result of less intensive screening in the elderly. For example, fewer elderly women receive regular breast palpation, mammograms, and pelvic examinations, even though older women are at higher risk for breast and gynecologic cancers. In addition, several studies suggest that older persons may not be treated as appropriately as younger persons, even taking into account complicating medical conditions. In brief, there seems to be considerable age bias by physicians in offering cancer screening and treatment to elderly patients. In addition, elderly persons sometimes contribute to these difficulties by failing to obtain screening tests that are recommended.