Prescribers' attitudes toward elderly breast cancer patients. Discrimination or empathy?

Advancing age is often associated with co-morbidities. Patients' chronological and physiological ages do not always correspond. Elderly patients are often excluded from clinical trials and given sub-optimum treatment. In this context, the question of equity in access to health care arises. A specially designed questionnaire was mailed to French oncologists to determine what factors influenced them and to elicit their medical practice using four clinical cases. Significant differences in treatment choice depending only on patient's age were observed. The likelihood of an elderly breast cancer patient undergoing chemotherapy was found to depend on physician specialty and gender, kind of care structure, physician's perception of the age at which patients become elderly, and their knowledge about geriatric assessments. Some physicians did not always prescribe potentially beneficial treatments when dealing with elderly patients. Given the multidimensional nature of the care process, patients' preferences should be taken into account in medical decision-making.