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

Lookup NU author(s): Dr Louise HayesORCiD, Dr Lynne Forrest, Dr Jean Adams, Professor Martin White, Professor Linda Sharp


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© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ. Background: 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.

Publication metadata

Author(s): Hayes L, Forrest L, Adams J, Hidajat M, Ben-Shlomo Y, White M, Sharp L

Publication type: Article

Publication status: Published

Journal: Journal of Epidemiology and Community Health

Year: 2018

Volume: 73

Issue: 1

Pages: 34-41

Print publication date: 11/12/2018

Online publication date: 08/11/2018

Acceptance date: 31/07/2018

ISSN (print): 0143-005X

ISSN (electronic): 1470-2738

Publisher: BMJ Publishing Group

URL: .https:/

DOI: 10.1136/jech-2018-210842


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