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Cancer Treatment Rates Low among Elderly Veterans


Cancer disproportionately affects our older population, with an 11-fold higher incidence of cancer in people over the age of 65 relative to their younger counterparts. Age is the single most important risk factor for developing cancer, yet toxicity concerns may lead to under-treatment of cancer in the elderly. This study examined elderly veterans diagnosed with lung, colorectal, prostate, or head and neck cancer in 2005 (n=194,797), comparing treatment by age group – 70 to 84 (younger elders) vs. 85 to 115 (older elders). Findings show that although the number of cancer diagnoses among veterans was high, treatment rates appeared low, particularly for the older elders. Treatment was more common among younger elders, including: surgery (1.3% vs. 0.6%), chemotherapy (2.1% vs. 0.8%), and radiation (1.7% vs. 0.7%). Differences were sharper for certain cancers; for example, chemotherapy for lung cancer (9.0% vs. 2.9%) and colorectal surgery (5.8% vs. 3.4%). Overall, the predominant diagnosis was prostate cancer (77%), followed by colorectal (13%), lung (10%), and head and neck cancer (3%).

Chemotherapy and radiation toxicities are a significant concern in the elderly; however, the authors suggest that it is possible that an exaggerated level of trepidation regarding these treatment ramifications may be an obstacle to appropriate treatment in patients who could benefit from it.

PubMed Logo Zeber J, Copeland L, Hosek B, Karnad A, Lawrence V, and Sanchez-Reilly S. Cancer rates, medical comorbidities, and treatment modalities in the oldest patients. Critical Reviews in Oncology/Hematology September 2008;67(3):237-42.

This study was funded through VA, including support through HSR&D’s VERDICT (Veterans Evidence-Based Research Dissemination and Implementation Center) and through Dr. Copeland’s HSR&D Career Development Award. Drs. Zeber, Copeland, Lawrence, and Mr. Hosek are all part of VERDICT.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.