Narrative review discusses inflammaging and immunosenescence in older adults with colorectal cancer
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Key Takeaway
Note that fundamental immunological mechanisms underlying risk in older adults with colorectal cancer remain incompletely understood.
This narrative review focuses on the intersection of inflammaging and immunosenescence within the context of colorectal cancer in older adults. The scope of the article is to synthesize current understanding of these biological processes in this specific patient population. No specific sample size or follow-up duration is reported for the evidence discussed within this commentary.
The authors highlight that fundamental immunological mechanisms which underlie this risk remain incompletely understood. This gap in knowledge limits the ability to draw definitive causal conclusions or establish precise risk estimates from the available literature. The review does not report specific adverse events, tolerability data, or primary outcomes associated with interventions.
Despite these limitations, the practice relevance of the review is that it may guide future endeavor in biomarker discovery, prevention, and therapeutic intervention. Clinicians should interpret these findings as a call for further research rather than established clinical guidelines. The certainty of the conclusions is constrained by the incomplete understanding of the underlying immunology.
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View Original Abstract ↓
Colorectal cancer (CRC) is one of the most commonly occurring malignancies worldwide, with incidence and mortality rising sharply in older adults. While aging is increasingly recognized as a key risk factor for CRC, the fundamental immunological mechanisms which underlie this risk remain incompletely understood. Two interconnected processes, namely inflammaging and immunosenescence, appear central to this association. On the one hand, inflammaging, which is characterized by chronic low-grade inflammation in older individuals, fosters a tumor-promoting microenvironment through oxidative stress, genomic instability, and persistent cytokine activation. On the other hand, immunosenescence diminishes immune surveillance, reducing the clearance of premalignant cells and weakening responses to tumor progression and therapy. Together, these processes create an immunological framework that predisposes the aging colon to malignant transformation. This review synthesizes current knowledge of the cellular and mechanistic impacts of inflammaging and immunosenescence in CRC pathogenesis, highlighting their roles in shaping disease susceptibility in the elderly. These insights may guide future endeavor in biomarker discovery, prevention, and therapeutic intervention to mitigate the burden of CRC in aging populations.
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