title: [Colorectal cancer: prevention and curative treatment in the elderly: An appraisal from the viewpoint of geriatric gastroenterology].
abstract: BACKGROUND
  More than half of colorectal cancers occur in patients older than 75 years. This group is not homogeneous but variably vulnerable to disease, diagnostics, treatment procedures and complications.
  
  
  OBJECTIVE
  This review highlights the age-specific aspects of diagnostics and screening, curative and adjuvant treatment and the prognostic and predictive value of a geriatric assessment.
  
  
  METHODS
  A survey was carried out based on a selection of the relevant literature.
  
  
  RESULTS
  The number of publications is currently rapidly increasing and even now it becomes apparent that a geriatric assessment carried out by the primary physician, can better predict therapy-linked adverse events and allow for a more individualized assessment of indications for diagnostics and screening of surgical and medicinal treatment. In particular this applies to total mesorectal resection and to the adjuvant use of oxaliplatin.
  
  
  CONCLUSIONS
  Even in the older age group screening colonoscopy and surgical and medicinal adjuvant treatment can be reasonably used when aligned to the results of a carefully performed geriatric assessment. A severely reduced life-expectancy (generally with more than 2 comorbidities) should lead to more conservative approaches.
authors.affiliation: Med. Klinik I, Ostalb-Klinikum Aalen, Akad. Lehrkrankenhaus der Universität Ulm, Kälblesrain 1, 73430, Aalen, Deutschland, Gerhard.Kleber@ostalb-klinikum.de.
authors.forename: G
authors.initials: G
authors.lastname: Kleber
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy*; D003131:Combined Modality Therapy; D005762:Gastroenterology; D015577:Geriatric Assessment; D005853:Geriatrics; D006801:Humans; D008403:Mass Screening; D016019:Survival Analysis