Determinants of cancer therapy in elderly patients

James Goodwin, W. C. Hunt, J. M. Samet

Research output: Contribution to journalArticle

202 Citations (Scopus)

Abstract

Background. Older patients with cancer are less likely to receive definitive therapy, but the reasons for this are unclear. Methods. All people aged 65 years or older living in six counties in New Mexico and diagnosed with breast, prostate, or colorectal cancer between May 15, 1984 and May 15, 1986 (N = 669) were interviewed to obtain information on demographics, socioeconomic status, functional status, social support, other medical conditions, and cognitive status. Cancer treatment information was obtained from the New Mexico Tumor Registry. Results. In univariate analyses, the following variables were associated significantly with nonreceipt of definitive therapy for cancer: advanced age, impairment in activities of daily living, low physical activity, decreased mental status, impaired access to transportation, and poor social support. In a multivariate analysis with the above variables along with measures of comorbidity, only advanced age and decreased mental status remained significant predictors of nonreceipt of definitive surgery, whereas the effects of impaired access to transportation and low physical activity remained relatively large but no longer were statistically significant. When receipt of surgery and receipt of radiation therapy were considered separately, older age, limited access to transportation, impaired functional status, and impaired mental status all significantly predicted nonreceipt of radiation therapy, but not surgery. Conclusions. There is a decline with age in the percentage of adults with cancer who receive definitive therapy independent of other potentially explanatory factors such as comorbidity. In addition, decisions about radiation may be influenced by nonmedical, potentially correctable factors such as impaired access to transportation.

Original languageEnglish (US)
Pages (from-to)594-601
Number of pages8
JournalCancer
Volume72
Issue number2
StatePublished - 1993
Externally publishedYes

Fingerprint

Neoplasms
Social Support
Comorbidity
Radiotherapy
Exercise
Therapeutics
Activities of Daily Living
Social Class
Registries
Colorectal Neoplasms
Prostatic Neoplasms
Multivariate Analysis
Demography
Radiation
Breast Neoplasms

Keywords

  • access to care
  • cancer
  • cancer therapy
  • comorbidity
  • dementia
  • functional status
  • geriatric oncology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Goodwin, J., Hunt, W. C., & Samet, J. M. (1993). Determinants of cancer therapy in elderly patients. Cancer, 72(2), 594-601.

Determinants of cancer therapy in elderly patients. / Goodwin, James; Hunt, W. C.; Samet, J. M.

In: Cancer, Vol. 72, No. 2, 1993, p. 594-601.

Research output: Contribution to journalArticle

Goodwin, J, Hunt, WC & Samet, JM 1993, 'Determinants of cancer therapy in elderly patients', Cancer, vol. 72, no. 2, pp. 594-601.
Goodwin J, Hunt WC, Samet JM. Determinants of cancer therapy in elderly patients. Cancer. 1993;72(2):594-601.
Goodwin, James ; Hunt, W. C. ; Samet, J. M. / Determinants of cancer therapy in elderly patients. In: Cancer. 1993 ; Vol. 72, No. 2. pp. 594-601.
@article{a0a8a01deb4f4e83b510f8ebb042997c,
title = "Determinants of cancer therapy in elderly patients",
abstract = "Background. Older patients with cancer are less likely to receive definitive therapy, but the reasons for this are unclear. Methods. All people aged 65 years or older living in six counties in New Mexico and diagnosed with breast, prostate, or colorectal cancer between May 15, 1984 and May 15, 1986 (N = 669) were interviewed to obtain information on demographics, socioeconomic status, functional status, social support, other medical conditions, and cognitive status. Cancer treatment information was obtained from the New Mexico Tumor Registry. Results. In univariate analyses, the following variables were associated significantly with nonreceipt of definitive therapy for cancer: advanced age, impairment in activities of daily living, low physical activity, decreased mental status, impaired access to transportation, and poor social support. In a multivariate analysis with the above variables along with measures of comorbidity, only advanced age and decreased mental status remained significant predictors of nonreceipt of definitive surgery, whereas the effects of impaired access to transportation and low physical activity remained relatively large but no longer were statistically significant. When receipt of surgery and receipt of radiation therapy were considered separately, older age, limited access to transportation, impaired functional status, and impaired mental status all significantly predicted nonreceipt of radiation therapy, but not surgery. Conclusions. There is a decline with age in the percentage of adults with cancer who receive definitive therapy independent of other potentially explanatory factors such as comorbidity. In addition, decisions about radiation may be influenced by nonmedical, potentially correctable factors such as impaired access to transportation.",
keywords = "access to care, cancer, cancer therapy, comorbidity, dementia, functional status, geriatric oncology",
author = "James Goodwin and Hunt, {W. C.} and Samet, {J. M.}",
year = "1993",
language = "English (US)",
volume = "72",
pages = "594--601",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Determinants of cancer therapy in elderly patients

AU - Goodwin, James

AU - Hunt, W. C.

AU - Samet, J. M.

PY - 1993

Y1 - 1993

N2 - Background. Older patients with cancer are less likely to receive definitive therapy, but the reasons for this are unclear. Methods. All people aged 65 years or older living in six counties in New Mexico and diagnosed with breast, prostate, or colorectal cancer between May 15, 1984 and May 15, 1986 (N = 669) were interviewed to obtain information on demographics, socioeconomic status, functional status, social support, other medical conditions, and cognitive status. Cancer treatment information was obtained from the New Mexico Tumor Registry. Results. In univariate analyses, the following variables were associated significantly with nonreceipt of definitive therapy for cancer: advanced age, impairment in activities of daily living, low physical activity, decreased mental status, impaired access to transportation, and poor social support. In a multivariate analysis with the above variables along with measures of comorbidity, only advanced age and decreased mental status remained significant predictors of nonreceipt of definitive surgery, whereas the effects of impaired access to transportation and low physical activity remained relatively large but no longer were statistically significant. When receipt of surgery and receipt of radiation therapy were considered separately, older age, limited access to transportation, impaired functional status, and impaired mental status all significantly predicted nonreceipt of radiation therapy, but not surgery. Conclusions. There is a decline with age in the percentage of adults with cancer who receive definitive therapy independent of other potentially explanatory factors such as comorbidity. In addition, decisions about radiation may be influenced by nonmedical, potentially correctable factors such as impaired access to transportation.

AB - Background. Older patients with cancer are less likely to receive definitive therapy, but the reasons for this are unclear. Methods. All people aged 65 years or older living in six counties in New Mexico and diagnosed with breast, prostate, or colorectal cancer between May 15, 1984 and May 15, 1986 (N = 669) were interviewed to obtain information on demographics, socioeconomic status, functional status, social support, other medical conditions, and cognitive status. Cancer treatment information was obtained from the New Mexico Tumor Registry. Results. In univariate analyses, the following variables were associated significantly with nonreceipt of definitive therapy for cancer: advanced age, impairment in activities of daily living, low physical activity, decreased mental status, impaired access to transportation, and poor social support. In a multivariate analysis with the above variables along with measures of comorbidity, only advanced age and decreased mental status remained significant predictors of nonreceipt of definitive surgery, whereas the effects of impaired access to transportation and low physical activity remained relatively large but no longer were statistically significant. When receipt of surgery and receipt of radiation therapy were considered separately, older age, limited access to transportation, impaired functional status, and impaired mental status all significantly predicted nonreceipt of radiation therapy, but not surgery. Conclusions. There is a decline with age in the percentage of adults with cancer who receive definitive therapy independent of other potentially explanatory factors such as comorbidity. In addition, decisions about radiation may be influenced by nonmedical, potentially correctable factors such as impaired access to transportation.

KW - access to care

KW - cancer

KW - cancer therapy

KW - comorbidity

KW - dementia

KW - functional status

KW - geriatric oncology

UR - http://www.scopus.com/inward/record.url?scp=0027294630&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027294630&partnerID=8YFLogxK

M3 - Article

C2 - 8319193

AN - SCOPUS:0027294630

VL - 72

SP - 594

EP - 601

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 2

ER -