Unit of Research, Majorca Department of Primary Health Care, Balearic Institute of Health, Reina Esclaramunda 9, 07003 Palma de Mallorca, Spain.
Unit of Research, Majorca Department of Primary Health Care, Balearic Institute of Health, Reina Esclaramunda 9, 07003 Palma de Mallorca, Spain.
Cancer Epidemiol. 2014 Aug;38(4):346-53. doi: 10.1016/j.canep.2014.05.002. Epub 2014 Jun 6.
The gap in survival between older and younger European cancer patients is getting wider. It is possible that cancer in the elderly is being managed or treated differently than in their younger counterparts. This study aims to explore age disparities with respect to the clinical characteristics of the tumour, diagnostic pathway and treatment of colorectal cancer patients.
We conducted a multicenter cross sectional study in 5 Spanish regions. Consecutive incident cases of CRC were identified from pathology services.
From patient interviews, hospital and primary care clinical records, we collected data on symptoms, stage, doctors investigations, time duration to diagnosis/treatment, quality of care and treatment.
777 symptomatic cases, 154 were older than 80 years. Stage was similar by age group. General symptoms were more frequent in the eldest and abdominal symptoms in the youngest. No differences were found regarding perception of symptom seriousness and symptom disclosure between age groups as no longer duration to diagnosis or treatment was observed in the oldest groups. In primary care, only ultrasound is more frequently ordered in those <65 years. Those >80 years had a significantly higher proportion of iron testing and abdominal XR requested in hospital. We observed a high resection rate independently of age but less adjuvant chemotherapy in Stage III colon cancer, and of radiotherapy in stage II and III rectal cancer as age increases.
There are no relevant age disparities in the CRC diagnosis process with similar stage, duration to diagnosis, investigations and surgery. However, further improvements have to be made with respect to adjuvant therapy.
欧洲老年癌症患者与年轻癌症患者之间的生存差距正在扩大。老年人的癌症治疗或管理方式可能与年轻患者不同。本研究旨在探讨与老年患者肿瘤的临床特征、诊断途径和治疗相关的年龄差异。
我们在西班牙的 5 个地区进行了一项多中心横断面研究。从病理科收集CRC 的连续新发病例。
通过对患者的访谈、医院和初级保健临床记录，我们收集了症状、分期、医生检查、诊断/治疗时间、护理质量和治疗的数据。
777 例有症状的病例中，154 例年龄大于 80 岁。年龄组之间的分期相似。最年长的患者出现一般症状更频繁，而最年轻的患者出现腹部症状更频繁。由于在最年长的组中未观察到诊断或治疗的时间延长，因此两组之间在对症状严重程度和症状披露的认知方面没有差异。在初级保健中，只有 <65 岁的患者更频繁地进行超声检查。在>80 岁的患者中，在医院中进行铁检测和腹部 X 光检查的比例显著更高。我们观察到与年龄无关的高切除率，但随着年龄的增长，III 期结肠癌的辅助化疗、II 期和 III 期直肠癌的放疗减少。
在 CRC 的诊断过程中，在分期、诊断时间、检查和手术方面，没有明显的年龄差异。然而，在辅助治疗方面还需要进一步改进。
