Dr Kirsty Colquhoun is a consultant geriatrician based in Glasgow and secretary of the BGS Oncogeriatrics Special Interest Group.
Wednesday 4 February 2026 is World Cancer Day. Cancer in the UK is heavily concentrated in older people: over 60% of all new cancer cases are diagnosed in people aged over 65. Globally the number of people aged over 65 living with cancer is projected to treble between 2010 and 2040. Despite this, older people have often been left behind when it comes to research, service development and policy.
There is a current social media trend in which people look back to where they were in 2016. If we reflect on the past decade of oncogeriatrics, while we can do more to improve the care that older people living with cancer receive, there is also much to celebrate. In the UK, the BGS and its members have been central to this.
A decade is a long time in the cancer treatment world and the treatments we have for older people, even those with advanced cancers, have changed. For example, immunotherapy has revolutionised the survival of some cancers. The ELDERS Study showed comparable efficacy between the older and younger population, and no significant increase in high-grade toxicity in older people. However, frailty did predict higher risk of hospitalisation.
ASCO 2020: The Geriatric Assessment Comes of Age by Soto-Perez-de-Celis et al, was pivotal in highlighting the importance of comprehensive geriatric assessment in cancer care, through four randomised controlled trials. These trials demonstrated improvements in quality of life and reductions in treatment toxicity, without negatively impacting on survival.
The Care of Older Patients with Cancer, Across the United Kingdom in 2024: A Narrative Review by the International Society of Geriatric Oncology UK Country Group highlighted the excellent service developments that are happening across the country, with many more services emerging since the last review in 2020. If we compare this to 2012, when there was only one oncogeriatric service with a geriatrician in the UK, this is hugely encouraging. However, access to specialist services like this remains patchy, depending on geography and cancer type.
The heterogeneity in services is mirrored by the irregularity of education and training in geriatric oncology. The BGS has been working hard to address this. It has worked collaboratively with the Royal College of Physicians, the Royal College of Radiologists, International Society of Geriatric Oncology and Macmillan Cancer Support to produce the guidelines: Implementing Frailty Assessment and Management in Oncology Services – released in November 2023. The guidelines ensure that an easily accessible and standardised framework is available to oncology and geriatric medicine teams as they consider how best to support their older population.
The BGS has also produced a multidisciplinary Oncogeriatrics elearning module, which is free for BGS members.
So, while we look at where we were in 2016 compared to where we are now, we have come on in leaps and bounds. But there is still much to do to ensure all older people receive the best cancer care.
