Cancer treatment ageism

May 12, 2000

Elderly patients are being denied treatment for lung cancer purely on the grounds of their age, researchers have found.

The study by experts from the Royal College of Physicians shows that older sufferers received lower levels of investigation and therapy, regardless of their general health.

Their work adds weight to growing concern about discrimination against elderly people within the National Health Service.

Michael Peake, a consultant physician at Pontefract General Infirmary, who led the work, said: "Older patients with exactly the same extent and type of lung cancer, prognostic factors and coexisting diseases were being less actively treated."

Surgery is usually the only hope of a cure for lung cancer. While the average age of a sufferer at the time of diagnosis is 70 years, age is thought to have a negligible effect on the outcome of treatment.

The research, coordinated by the RCP's clinical effectiveness and evaluation unit, was presented to the American Thoracic Society conference in Toronto, Canada, on Wednesday.

It tracked the progress of 1,652 lung cancer patients who had been referred to a specialist at 47 hospitals in the United Kingdom in 1997 and 1998. These were divided into three age groups: below 65 years; between 65 and 74 years; and 75 years and above.

The researchers found the older the patient, the less chance there was of receiving a pathological diagnosis, any sort of active treatment, or access to surgery or chemotherapy.

This was the case even when account was taken of the patient's fitness, the extent of the cancer, the existence of other conditions, such as heart disease, and medical factors that could impact on the prognosis.

For instance, in non-small cell lung cancer, 37 per cent of the under 65s were operated on, compared with just 15 per cent of the over 74s. This translates directly into survival, with 76 per cent of the youngest group still alive after six months and just 58 per cent of the oldest.

Sandy Thompson, coordinator of the RCP's lung cancer programme, said the reasons behind the apparent discrimination had not been studied.

"It is very sad that the older you are, the less likely you are to get a fair deal," she said.

David Hinchcliffe, chairman of the House of Commons health select committee, said elderly people seemed less prepared to demand help.

"I find this particularly offensive as it was the older generation that fought for the establishment of the NHS," he said.

Betty Arrol, health policy officer with Age Concern, said thousands of patients had complained to the charity of age discrimination. She said that the study added weight to calls for a government inquiry into the problem.

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