LIH researcher calls for older adults to be systematically included in cancer research

A commentary co-authored by Dr Sophie Pilleron from the Luxembourg Institute of Health (LIH) calls for older adults to be systematically included in cancer research, from prevention to end-of-life care.

• Ageing, Cancer, and Disparities Research Unit – ACADI
• Department of Precision Health

Although adults aged 65 and over account for the majority of cancer diagnoses worldwide, they remain underrepresented in research, limiting the evidence available to guide their care.

Dr Sophie Pilleron, from the Ageing, Cancer and Disparities Research Unit at the Luxembourg Institute of Health (LIH), was the lead author on a commentary calling for a fundamental shift in cancer research. Published in Nature Reviews Clinical Oncology, the article, entitled “No cancer research without older adults, from prevention to end of life: a manifesto”, was written with Dr Enrique Soto-Perez-de-Celis and Dr Nicolò Matteo Luca Battisti, both specialists in geriatric oncology.

The authors highlight a striking mismatch between cancer incidence and research priorities. Adults aged 65 and over accounted for an estimated 52% of new cancer diagnoses worldwide in 2024, yet an analysis of global cancer research funding found that only 0.3% of funding between 2016 and 2020 specifically targeted this age group.

Barriers to participation leave important gaps in cancer research.

Older adults can be excluded from clinical trials through upper age limits and eligibility criteria that screen out common age-related conditions. Other barriers include difficulties travelling to study sites and assumptions about older patients’ ability or willingness to participate. The resulting evidence gap extends beyond treatment to prevention, screening, survivorship, palliative care and end-of-life care.

We need to ensure that cancer research reflects the people most affected by the disease, so that older adults can benefit from evidence-based care tailored to their needs,

says Dr Sophie Pilleron, leader of the Ageing, Cancer and Disparities Research Unit (ACADI) at the LIH.

The authors call for research that reflects older people’s needs.

The commentary calls on funders, regulators, researchers and scientific journals to make inclusion the norm. Proposed measures include dedicated research funding, broader trial eligibility criteria, and better reporting of participants’ ages and health status. The authors also advocate for outcomes that matter to older people, such as maintaining independence and physical function and cognition.

They emphasise that older adults are not a homogeneous group, research must account for differences in frailty, comorbidities and individual care goals, while involving older people and their caregivers in study design.

Systematic inclusion must become standard across the cancer care continuum.

By publishing this call to action in a leading oncology journal, the authors seek to establish the inclusion of older adults as a standard across the entire cancer research continuum, helping to ensure that advances in cancer care benefit the populations who need them.