학술논문
Cancer Treatment Patterns and Factors Affecting Receipt of Treatment in Older Adults: Results from the ASPREE Cancer Treatment Substudy (ACTS).
Document Type
Article
Author
Source
Subject
*TUMOR treatment
*CONFIDENCE intervals
*DESCRIPTIVE statistics
*ODDS ratio
*LOGISTIC regression analysis
*CANCER patient medical care
*ELDER care
*OLD age
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Language
ISSN
2072-6694
Abstract
Simple Summary: Planning and delivering cancer treatment in older adults with cancer is complex, given the difficulty in balancing the benefits of treatment on survival and quality of life, and the risk of harmful side effects. As a result, treatment rates in older adults with cancer tend to differ from younger patients, and there are few reports describing treatment rates in older adults. In a group of healthy older patients with cancer, we looked at rates of treatment classed as surgery, drug therapies such a chemotherapy or immunotherapy, and radiotherapy, and found that the vast majority received some form of treatment (81%), most commonly, surgery. Those with breast cancers were most likely to receive treatment (98%), in contrast to blood cancers, where patients were least likely to receive treatment (only 60% received treatment). Older patients, those residing in the US, current smokers, and those with diabetes were also less likely to receive treatment. Introduction: Cancer treatment planning in older adults is complex and requires careful balancing of survival, quality of life benefits, and risk of treatment-related morbidity and toxicity. As a result, treatment selection in this cohort tends to differ from that for younger patients. However, there are very few studies describing cancer treatment patterns in older cohorts. Methods: We used data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and the ASPREE Cancer Treatment Substudy (ACTS) to describe cancer treatment patterns in older adults. We used a multivariate logistic regression model to identify factors affecting receipt of treatment. Results: Of 1893 eligible Australian and United States (US) participants with incident cancer, 1569 (81%) received some form of cancer treatment. Non-metastatic breast cancers most frequently received treatment (98%), while haematological malignancy received the lowest rates of treatment (60%). Factors associated with not receiving treatment were older age (OR 0.94, 95% CI 0.91–0.96), residence in the US (OR 0.34, 95% CI 0.22–0.54), smoking (OR 0.57, 95% CI 0.40–0.81), and diabetes (OR 0.56, 95% CI 0.39–0.80). After adjustment for treatment patterns in sex-specific cancers, sex did not impact receipt of treatment. Conclusions: This study is one of the first describing cancer treatment patterns and factors affecting receipt of treatment across common cancer types in older adults. We found that most older adults with cancer received some form of cancer treatment, typically surgery or systemic therapy, although this varied by factors such as cancer type, age, sex, and country of residence. [ABSTRACT FROM AUTHOR]