Some Elders With Rectal Cancer Don't Receive Tx
Worse overall survival was seen in association with male sex, older age, worsening comorbidities, and receiving no treatment or undergoing surgery alone.
(HealthDay News) — About 15% of octogenarians and nonagenarians with stage II/III rectal adenocarcinoma do not receive treatment, according to a study published online in Cancer.
Richard J. Cassidy, MD, from the Winship Cancer Institute of Emory University in Atlanta, and colleagues examined the impact of therapies on overall survival for 2723 patients with stage II/III rectal adenocarcinoma, and identified predictors of therapy using data from the National Cancer Data Base.
Overall, 14.9%, 29.7%, 5.0%, 45.3%, and 5.1% of patients received no treatment, surgery alone, short-course radiation then surgery (RT + S), chemoradiation and surgery (CRT + S), and surgery then chemoradiation (S + CRT), respectively. The researchers observed correlations for African-American race and residence in a less educated county with not receiving treatment. Worse overall survival was seen in association with male sex, older age, worsening comorbidities, and receiving no treatment or undergoing surgery alone. No statistical difference was seen in overall survival between RT + S, S + CRT, and CRT + S. CRT + S improved overall survival in interaction testing, independently of age, comorbidity status, sex, race, and tumor stage. CRT + S correlated with improved overall survival in comparison with surgery alone in the propensity score-matched analysis.
"African-American race and living in a less educated community are associated with not receiving therapy," the authors write.
- Cassidy RJ, Switchenko JM, Cheng E, et al. Health care disparities among octogenarians and nonagenarians with stage II and III rectal cancer. Cancer. 31 July 2017. doi: 10.1002/cncr.30896