Ya a zel kanser insidans h zlar ileri ya larda neden dü üyor? Kohort etkisi mi, sa kal m yan lg s m , yoksa ya l lar n uygun sa l k hizmetine ula mas ndaki sorunun g stergesi mi?

zet Ama : al man n amac Türkiye’de ya l nüfusta g zlenen kanser insidans h zlar ndaki dü ü ü irdelemektir. Y ntem: Bu al mada Be K tada Kanser G rülü ü, IX (Cancer Incidence in Five Continents, IX)’da yay mlanm olan zmir ve Antalya illerinde 1998-2002 y llar nda saptanan ya a zel kanser insidans h zlar de erlendirildi.Bulgular: zmir ve Antalya illerinde tüm kanserler i in ve hemen her kanser i in 64 ya üzerindeki gruplarda her iki cinsiyette de ya a zel insidans h zlar nda belirgin dü ü e imi g rülmektedir. Sonu : Türkiye’de ya l gruplar n insidans h zlar nda, pek ok kanser i in belirgin dü ü ler s z konusudur. Oysa ger ekte pek ok epitelyal kanserde insidans h z ya la birlikte artar. zmir ve Antalya’da geli mekte olan di er ülkelerdekine benzer ekilde g zlenen bu rüntüyü a klamak i in ü varsay mdan s zedebiliriz: 1. Ya l lar n uygun sa l k hizmetlerine ula malar ndaki eksiklik (tan konmas ndaki azl k), 2. Kohort etkisi, 3. Sa kal m yan lg s . Türkiye’de kanser kay t l ndaki geli meler bu soruyu ilerde daha a k yan tlayabilecek olanaklar sa layacakt r. Anahtar Kelimeler: Kanser insidans , ya l l k, Türkiye Abstract Aim: Our purpose was to evaluate the decline in cancer incidence rates in the elderly in Turkey. Methods: Age specific cancer incidence rates for Izmir and Antalya in 1998-2002, which have been published in Cancer Incidence in Five Continents, IX were evaluated. Results: In both Izmir and Antalya, for both sexes, age specific incidence rates are decreasing with age significantly after the age of 64. Conclusion: Despite the fact that the incidences of most of the epithelial cancers increase with age, there are obvious decreases in cancer incidence rates in the oldest age groups in most sites in Turkey. Three main resons may be suggested for these decreases: 1, Underdiagnosis due to a lack of access to appropriate health services for the elderly; 2, A Cohort Effect and 3, Survival bias. The recent developments in cancer registration in Turkey are promising to provide more clear answers to these questions as well as to many others.Key Words: Cancer incidence, elderly, Turkey