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

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cam.issuedOnline2018-11-08
dc.contributor.authorHayes, Louise
dc.contributor.authorForrest, Lynne
dc.contributor.authorAdams, Jean
dc.contributor.authorHidajat, Mira
dc.contributor.authorBen-Shlomo, Yoav
dc.contributor.authorWhite, Martin
dc.contributor.authorSharp, Linda
dc.contributor.orcidHayes, Louise [0000-0001-6442-4150]
dc.date.accessioned2020-06-12T23:30:21Z
dc.date.available2020-06-12T23:30:21Z
dc.date.issued2019-01
dc.description.abstractBACKGROUND: 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.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.53833
dc.identifier.eissn1470-2738
dc.identifier.issn0143-005X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/306745
dc.languageeng
dc.language.isoeng
dc.publisherBMJ
dc.publisher.urlhttp://dx.doi.org/10.1136/jech-2018-210842
dc.rightsAll rights reserved
dc.subjectcancer
dc.subjectinequalities
dc.subjectregisters
dc.subjectAge Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectColonic Neoplasms
dc.subjectComorbidity
dc.subjectEngland
dc.subjectFemale
dc.subjectHealthcare Disparities
dc.subjectHumans
dc.subjectIncidence
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeoplasm Staging
dc.subjectPatient Selection
dc.subjectRegistries
dc.titleAge-related inequalities in colon cancer treatment persist over time: a population-based analysis.
dc.typeArticle
dcterms.dateAccepted2018-07-31
prism.endingPage41
prism.issueIdentifier1
prism.publicationDate2019
prism.publicationNameJ Epidemiol Community Health
prism.startingPage34
prism.volume73
rioxxterms.licenseref.startdate2019-01
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1136/jech-2018-210842

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