Cancer
Conditions
Keywords
Elderly, Cancer, Cohort study, Cancer registry, Access to care, Cancer stage, Cancer treatment, Prognosis, Functional decline, Survival
Brief summary
The growing incidence of cancer associated to an aging population represents an epidemiologic reality that requires questioning access to care and prognosis in elderly with cancer, for which disparities have been highlighted. However, generally speaking, studies are limited in that they overlook geriatric-specific factors. The aim of this work was to study sociodemographic, socioeconomic and clinical determinants of access to care (cancer stage, cancer treatment) and prognosis (functional decline, survival) in elderly cancer patients.
Detailed description
The French department of Gironde (1.5 million inhabitants) is covered by cancer registries. In addition, three cohorts were initiated in Gironde on cerebral and functional aging that enrolled subjects aged 65 years and over: the PAQUID study (1988), the 3-City study (1999), and the AMI study (2007). In these cohorts, a large amount of individual data on the participants has been collected longitudinally at different follow-up visits, conducted every two or three years. Using cancer registries, older subjects with cancer were identified in the cohort studies. Subjects were included if they presented the following: i) aged 65 years and over from one of the three cohorts, ii) alive on January 1st 2005 (common start date for tumor recording) and resident in Gironde, and iii) with a validated cancer diagnosis recorded in one of the cancer registries from January 1st 2005 to December 31st 2014. All tumors for which data is annually sent by cancer registries to the International Agency for Research of Cancer were included: invasive malignant tumors and benign tumors of the central nervous system. As the incidence of skin tumors in older cancer patients is high, they were also included. For patients with multiple tumors, only one was considered: either the first one diagnosed if there were several tumors with a minimum of a 6 months interval between their diagnosis, or the one with the worse prognosis if there were several tumors diagnosed within 6 months. In order to not consider information concerning patients' characteristics that was too old, subjects with a delay between the last completed cohort follow-up visit before the cancer diagnosis and the diagnosis of cancer equal or superior to 6 years were excluded. Variables were extracted from cohorts and registries at different times: cohort inclusion, pre-diagnosis visit, cancer diagnosis or registries follow-up.
Interventions
OTHERAny cancer treatment
Sponsors
Institut National de la Santé Et de la Recherche Médicale, France
University of Bordeaux
Institut Bergonié
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 65 years * Alive on January 1st 2005 ( PAQUID or 3-City cohorts) or included in the AMI cohort study * Cancer diagnosis recorded in one of the cancer registries in Gironde, French department
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Patients Being Receiving Treatment Administration After Diagnosis | At diagnosis | Treatment administration was defined as any cancer treatment (versus no treatment) including curative, palliative and symptomatic treatments. This information was registered by registries and qualified as unknown when no information was available about treatment receipt. |
| The Probability of Being Dead at One Year | one year after diagnosis | The probability of being dead with or without receiving cancer treatment at least once (death) |
Countries
France
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Older Patients With Cancer Subjects i) aged 65 years and over from the PAQUID, the 3City or the AMI study; ii) alive on January 1st 2005 (common start date of tumor recording); iii) resident in Gironde; and iv) with a validated cancer diagnosis recorded in one of the cancer registries from January 1st 2005 to December 31st 2014. We included all invasive malignant tumors (including skin tumors) and benign tumors of the central nervous system. For patients with multiple tumors, only one was considered: i) the first one diagnosed if there were several tumors with a minimum of a 6 months interval between their diagnosis, ii) the one with the worse prognosis if there were several tumors diagnosed within less than 6 months.
Any cancer treatment | 450 |
| Total | 450 |
Baseline characteristics
| Characteristic | Older Patients With Cancer |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 450 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants |
| Region of Enrollment France | 450 participants |
| Sex: Female, Male Female | 204 Participants |
| Sex: Female, Male Male | 246 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 160 / 450 |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Primary
Proportion of Patients Being Receiving Treatment Administration After Diagnosis
Treatment administration was defined as any cancer treatment (versus no treatment) including curative, palliative and symptomatic treatments. This information was registered by registries and qualified as unknown when no information was available about treatment receipt.
Time frame: At diagnosis
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Older Patients With Cancer | Proportion of Patients Being Receiving Treatment Administration After Diagnosis | 372 Participants |
Primary
The Probability of Being Dead at One Year
The probability of being dead with or without receiving cancer treatment at least once (death)
Time frame: one year after diagnosis
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Older Patients With Cancer | The Probability of Being Dead at One Year | 35.5 percentage of participants |