A new study finds that while older Canadians are diagnosed with serious kinds of cancer, they don't receive the same life-extending treatments as younger patients.
The study, which looked at several aspects of cancer detection and treatment in Canada, found that chemotherapy and radiation were much more likely to be offered to younger cancer patients than those over the age of 70.
For example, among colon cancer patients, chemotherapy was offered to close to 80 per cent of patients under the age 60 after surgery, but given to less than 50 per cent of patients over the age of 70. That's despite the fact that clinical guidelines based on several years of research recommend chemo for both younger and older patients.
Among breast cancer patients, only 40 per cent of those over 70 received radiation following breast-conserving surgery, compared to 85 per cent of patients younger than 80.
The study comes from the Canadian Partnership Against Cancer, an independent organization responsible for leading Canada’s national cancer-control strategy.
The study authors note there could be several legitimate reasons why older Canadians often don’t get the same treatments as younger Canadians. For example, older patients are more likely to have other chronic health problems, which could make the risks of chemotherapy or radiation outweigh any potential benefits.
But the authors also suggest that these factors likely explain only a part of a so-called "age-related treatment gap."
Dr. Heather Bryant, vice-president of cancer control at the Canadian Partnership Against Cancer, says the risk of cancer increases with age, with more than 40 per cent of cancer cases occurring in Canadians older than 70.
But she notes that as Canada’s population ages, the number of older cancer patients is also rising and this report shows that these Canadians are not always receiving the treatments "that could affect their course of care.”
Not many cancer patients dying at home
The study looked at several aspects of how cancer is prevented, detected and treated in Canada, bringing in findings from provincial cancer agencies, Statistics Canada, and other national and provincial partners. The aim of the partnership is to examine opportunities for cross-Canadian system improvements, and to promote the exchange and use of best practices across the country.
The report also found while most cancer patients say they would prefer to die at home, only 10 to 13 per cent of cancer patients actually do; the vast majority die in hospital. This contrasts sharply with what happens in many European countries, where the majority of cancer patients are able to die at home with proper support systems.
As well, the report revealed that many Canadian patients were unsatisfied with their cancer care because of a lack of emotional support during their illness. Nearly one-third of women with cervical, uterine or ovarian cancer gave negative ratings for the emotional-support dimension of care, while about one in five men with prostate or testicular cancer reported being dissatisfied.
On the good news front, the report found that death rates are dropping among men with lung cancer and pancreatic cancer. As well, the five-year relative survival rates have improved for breast, prostate and colorectal cancers.
Screening targets being met
Also, between 2008 and 2012, all provinces showed an increase in the percentage of Canadians who reported being up-to-date with their colorectal cancer screenings, through either fecal occult blood test or colonoscopy.
As well, nine of 10 provinces reported in 2012 they had achieved their target of providing radiation to at least 90 per cent of patients within 28 days of a patient being ready for treatment. Only Nova Scotia fell short. Saskatchewan and Ontario reported the shortest median wait time at 15 days.
But the wait between receiving abnormal screening results and determining whether a patient actually has cancer is still taking too long for cases of breast and colorectal cancer.
The report found that none of the provinces reporting on this wait time achieved the recommended 60-day benchmark target. In Saskatchewan, for example, patients with abnormal fecal screens faced median wait times of 96 days for a follow-up colonoscopy.
