随着很多国家人口老龄化的经历，癌症患者也变得越来越老，先前的共病症也变多，包括普遍的、与年龄相关的慢性疾病，例如痴呆症。患有痴呆症的人更容易出现健康差距，而痴呆症对癌症治疗过程中的护理和结果影响会变得越来越大。本报告概述了痴呆症及其在患有癌症的患者中的普遍程度，并总结了对患有痴呆症的癌症患者护理的研究文献。回顾的研究表明，患有痴呆症的患者更容易被诊断为晚期癌症，接受较少或不接受癌症治疗，以及癌症诊断后的生存率较差。这些癌症差异不一定意味着痴呆症患者作为一个群体在诊断较晚或治疗较少，因此也不是治疗优化的合适或可行的目标。回顾的研究表明，患有痴呆症的患者还面临着与癌症有关的急诊情况风险增加、癌症决策制定质量较低、癌症调查和治疗方面的可达性障碍、治疗负担和家庭照顾者负担增加，以及癌症相关疼痛得不到充分治疗等问题。作者建议，针对患有痴呆症的癌症患者进行最佳护理时，应该专注于预防和减轻这些风险，并因此必须高度以人为中心，采用全面的决策制定，个性化的合理实践调整，以及强有力的家庭照顾者的包容和支持。文章提出了全面的临床实践建议和未来研究，以帮助临床医生和提供者为患有痴呆症的癌症患者及其家人提供最佳和公平的癌症护理。© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.

As many countries experience population aging, patients with cancer are becoming older and have more preexisting comorbidities, which include prevalent, age-related, chronic conditions such as dementia. People living with dementia (PLWD) are vulnerable to health disparities, and dementia has high potential to complicate and adversely affect care and outcomes across the cancer trajectory. This report offers an overview of dementia and its prevalence among patients with cancer and a summary of the research literature examining cancer care for PLWD. The reviewed research indicates that PLWD are more likely to have cancer diagnosed at an advanced stage, receive no or less extensive cancer treatment, and have poorer survival after a cancer diagnosis. These cancer disparities do not necessarily signify inappropriately later diagnosis or lower treatment of people with dementia as a group, and they are arguably less feasible and appropriate targets for care optimization. The reviewed research indicates that PLWD also have an increased risk of cancer-related emergency presentations, lower quality processes of cancer-related decision making, accessibility-related barriers to cancer investigations and treatment, higher experienced treatment burden and higher caregiver burden for families, and undertreated cancer-related pain. The authors propose that optimal cancer care for PLWD should focus on proactively minimizing these risk areas and thus must be highly person-centered, with holistic decision making, individualized reasonable adjustments to practice, and strong inclusion and support of family carers. Comprehensive recommendations are made for clinical practice and future research to help clinicians and providers deliver best and equitable cancer care for PLWD and their families.© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.