A new study has identified the leading risk factor for cancer — and it's not smoking, alcohol, or sun exposure. Instead, the primary risk factor is aging. As people grow older, their risk of developing cancer increases significantly. This is especially important because older adults are the fastest-growing population in Canada and around the world. By 2068, nearly 29% of Canadians will be over the age of 65. Since cancer is among the most common diseases in this group, it's crucial to rethink how we provide cancer care for older adults to meet their specific needs. International guidelines, including those from the American Society of Clinical Oncology, recommend that all older adults undergo a geriatric assessment before deciding on cancer treatment. This assessment is typically conducted by a geriatrician, a specialist who evaluates the overall health and functional abilities of older adults. Geriatricians consider how treatment might affect a person’s thinking, daily activities, existing health conditions, and life expectancy. They also focus on what matters most to the individual and their support system, ensuring that decisions about treatment are aligned with the patient's preferences and values. When older adults are diagnosed with cancer, they often undergo various tests and evaluations. However, research shows that these tests may not be as effective as a geriatric assessment in identifying underlying health issues that could affect treatment outcomes. In Canada, specialized geriatric oncology clinics are still limited, with only a few existing in cities like Montreal and Toronto. Researchers are in contact with clinics in Ontario and Alberta that are developing similar programs, and they hope to see more of these clinics established soon. A study led by Dr. Shabbir Alibhai found that these clinics can save about $7,000 per patient, which could lead to significant cost savings for the public health system when scaled up. Despite the strong evidence supporting geriatric assessments, they are not yet a standard part of cancer care across Canada. In British Columbia, for example, there are currently no specialized services for older adults with cancer. Over the past five years, researcher Kristen Haase and her team have worked with over 100 members of the cancer community to understand the need for these services. Their research involved interviews with older adults undergoing treatment, caregivers, and volunteers who provide support services like transportation. Healthcare professionals, including oncologists, nurses, and social workers, also emphasized the need for better support systems to effectively care for older adults with cancer. The lack of specialized cancer services for older adults can be attributed to several factors. Cost is a major barrier, but studies show that the savings from these services could offset the initial investment. Another challenge is the shortage of geriatricians, though nurse-led models have shown promise in delivering effective care at a lower cost. In addition, there is resistance to change in the current clinical model, which has remained largely unchanged for over 30 years. Finally, ageism — discrimination based on age — may be a hidden but significant barrier. Just as we would be outraged if children with cancer couldn’t access a pediatrician, it's concerning that older adults often face similar barriers in accessing appropriate care. Addressing these issues is essential for ensuring that all patients, regardless of age, receive the care they need.