Age-related inequalities in colon cancer treatment persist over time: a population-based analysis.
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Authors
Forrest, Lynne
Hidajat, Mira
Ben-Shlomo, Yoav
Sharp, Linda
Publication Date
2019-01Journal Title
J Epidemiol Community Health
ISSN
0143-005X
Publisher
BMJ
Volume
73
Issue
1
Pages
34-41
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Hayes, L., Forrest, L., Adams, J., Hidajat, M., Ben-Shlomo, Y., White, M., & Sharp, L. (2019). Age-related inequalities in colon cancer treatment persist over time: a population-based analysis.. J Epidemiol Community Health, 73 (1), 34-41. https://doi.org/10.1136/jech-2018-210842
Abstract
BACKGROUND: Older people experience poorer outcomes from colon cancer. We examined if treatment for colon cancer was related to age and if inequalities changed over time. METHODS: Data 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. RESULTS: Age-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. CONCLUSIONS: Age 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.
Keywords
Humans, Colonic Neoplasms, Neoplasm Staging, Registries, Incidence, Age Factors, Comorbidity, Patient Selection, Aged, Aged, 80 and over, Middle Aged, England, Female, Male, Healthcare Disparities
Identifiers
External DOI: https://doi.org/10.1136/jech-2018-210842
This record's URL: https://www.repository.cam.ac.uk/handle/1810/306745
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