Age-related inequalities in colon cancer treatment persist over time: a population-based analysis

BackgroundOlder people experience poorer outcomes from colon cancer. We examined if treatment for colon cancer was related to age and if inequalities changed over time.MethodsData from the UK population-based Northern and Yorkshire Cancer Registry on 31 910 incident colon cancers (ICD10 C18) diagnosed between 1999–2010 were obtained. Likelihood of receipt of: (1) cancer-directed surgery, (2) chemotherapy in surgical patients, (3) chemotherapy in non-surgical patients by age, adjusting for sex, area deprivation, cancer stage, comorbidity and period of diagnosis, was examined.ResultsAge-related inequalities in treatment exist after adjustment for confounding factors. Patients aged 60– 69, 70–79 and 80+ years were significantly less likely to receive surgery than those aged <60 years (multivariable ORs (95% CI) 0.84(0.74 to 0.95), 0.54(0.48 to 0.61) and 0.19(0.17 to 0.21), respectively). Age-related differences in receipt of surgery and adjuvant chemotherapy (but not chemotherapy in non-surgical patients) narrowed over time for the ’younger old’ (aged <80 years) but did not diminish for the oldest patients.ConclusionsAge inequality in treatment of colon cancer remains after adjustment for confounders, suggesting age remains a major factor in treatment decisions. Research is needed to better understand the cancer treatment decision-making process, and how to influence this, for older patients.

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Quality of diagnostic procedure and treatment decision making in lung cancer. Results of an population based investigation

Lung Cancer ◽

10.1016/s0169-5002(00)80820-x ◽

2000 ◽

Vol 29 (1) ◽

pp. 238-239

Author(s):

W Schütte ◽

H Neef ◽

J Haerting ◽

T Blankenburg

Keyword(s):

Lung Cancer ◽

Decision Making ◽

Diagnostic Procedure ◽

Treatment Decision ◽

Population Based ◽

Treatment Decision Making

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Variation in reported experience of involvement in cancer treatment decision making: evidence from the National Cancer Patient Experience Survey

British Journal of Cancer ◽

10.1038/bjc.2013.316 ◽

2013 ◽

Vol 109 (3) ◽

pp. 780-787 ◽

Cited By ~ 30

Author(s):

A El Turabi ◽

G A Abel ◽

M Roland ◽

G Lyratzopoulos

Keyword(s):

Decision Making ◽

Cancer Patient ◽

Cancer Treatment ◽

Patient Experience ◽

Treatment Decision ◽

Treatment Decision Making ◽

Experience Survey

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The Significance of Patient-Reported Outcomes for Metastatic Breast Cancer Patients

Oncology Research and Treatment ◽

10.1159/000521826 ◽

2022 ◽

Author(s):

Larissa Elisabeth Hillebrand ◽

Ulrike Söling ◽

Norbert Marschner

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Metastatic Breast Cancer ◽

Cancer Treatment ◽

Patient Reported Outcomes ◽

Metastatic Breast ◽

Treatment Decision ◽

Breast Cancer Patients ◽

Treatment Decision Making ◽

Patient Reported

Background: Breast cancer is still the most common malignancy in women worldwide. Once metastasized, breast cancer treatment primarily aims at reducing symptom burden, thereby trying to maintain and improve a patient´s quality of life (QoL), delaying disease progression, and prolonging survival. Curing the disease is not possible in the palliative setting. To better understand metastatic breast cancer patients, their symptoms and wishes, which are important for treatment-decision making and outcome, patient-reported outcomes (PROs) are of great importance, giving an impression of what really matters to and concerns a patient. Summary: Many advances have been made to implicate PROs in clinical trials, non-interventional studies, registries, and clinical routine care of metastatic breast cancer. For example, large phase III trials like PALOMA-3 (NCT01942135), MONALEESA-7 (NCT02278120), HER2CLIMB (NCT02614794), and KEYNOTE-119 (NCT02555657) trials implemented PROs in their trial design to assess the QoL of their trial patients. Also, non-interventional studies on metastatic breast cancer, like e.g., the NABUCCO study (IOM-02240), and prospective non-interventional, multicenter registries e.g., the tumor registry breast cancer (NCT01351584) or the breast cancer registry platform OPAL (NCT03417115), have implemented PROs to assess QoL during the anti-cancer treatment periods of the patients. Key Message: Using PROs in metastatic breast cancer can support shared treatment-decision making and management of symptoms, eventually leading to an improvement in QoL. Progressively, regulatory authorities take PROs into consideration for the approval of new drugs. Hence, the implication of PROs in cancer treatment, and especially in MBC, is of significant value.

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