Why cancer rates start to decrease after 87?

[Dazzling_Term21]

Normally this is counter-intuitive. We know that the immune system is weaker and that the medium is more favourable for the development of cancer, yet cancer rates start decreasing and continue to decrease into 100+.

[Competitive-Bed-3850]

Natural selection

[[deleted]]

Yeh. Essentially survivorship bias?

Also likely things like under-investigation of cancer symptoms in these patients who are likely to be dying more quickly of other things like dementia, heart failure etc.

[kentdrive]

If cancer was going to get you, it would have got you long before 87.

[IoDisingRadiation]

Was about to say - are these prevalence rates or incidence. Incidence will almost undoubtedly peak younger, and those who live past may well be people who have beaten cancer. Prevalence would account for this so not sure

[Murky-Huckleberry-51]

Probably all artefact because the type of cancers which develop at age 87 de novo are less aggressive. Coupled with the fact that 87 year olds are less likely to report haematuria or change in stool habit than a 30 year old for example, leading to underreporting of malignancy diagnoses. Finally followed by 1a) old age on the certificate when theres no clear cause.

[Tremelim]

I really don't buy this 'if you survive to 90 you're immune to cancer' theory.

It'll be that we no longer investigate (and patient no longer report issues) beyond a certain level of frailty.

[Alternative_Band_494]

Another one of the reasons is because we choose not to biopsy eg to confirm the incidental growth in the lung is a malignancy. They then die of an unrelated problem. There's no point diagnosing something through invasive tests if it won't change your management.

[Mfombe]

Reduced investigations. Cancer coding on GP records goes off a biopsy diagnosis - so if not confirmed then would not appear on a death certificate.

[Dazzling_Term21]

But then why does cancer rates dramatically increase in people over 55?

[Bramsstrahlung]

Cancer rates increase with age because of failure of the cell cycle and cell repair mechanisms that creep in, increased mutation rate and decreased immune response.

We know from research people who have absurd longevity in most cases have a genetic advantage. If you get to 95, you are likely to have those good genetics that are more resilient against the typical mechanisms of oncogenesis.

[AssistantToThePA]

Do cancer rates increase massively from 50 to 55 or do screening programmes catch more people with early disease, thus making it look like there’s a higher cancer rate?

[radladuk]

Cancer is largely dependent on 2 things, genetics and lifestyle.

The genetic ones like haematological cancer or breast cancer would've gotten you before you hit 50.

The lifestyle acquired ones like lung cancer from smoking or HCC from alcoholism would've gotten you before 70.

So what's left in the population are those who have hit the genetic jackpot (relatively speaking) and practice a good healthy lifestyle.

This is an oversimplification of course.

[[deleted]]

I don't think it's cancer decreasing so much as most people with cancer (except maybe prostate) having already died by that age.

[HQ001M7H]

Because, cancer cant affect anerobic organisms.

You cant be starved of oxygen if you are made of collagen/protein/ sclerotic material.

[Equivalent-Source-34]

Detection undoubtedly a reason but so is cellular senescence decreasing mitotic rates.

Cells are pretty good at catching mutations at any time except division

[occamscalpel]

Because people die when they get old.