Finding: Ageism affects cancer survival

March 21, 2003

Ageism could be affecting the survival rate of lung cancer patients in Britain, which is well below the European average, according to researchers from London, writes Natasha Gilbert.

In a study published in the journal Age and Aging , Michael Peake from the Clinical Effectiveness and Evaluation Unit at the Royal College of Physicians and his team found that poor survival in older patients was a result of undertreatment.

Surgery is the best chance of beating the cancer, and many doctors claim that post-operative survival is independent of age. But of 1,652 patients, 15 per cent of those aged 75 years and over underwent surgery compared with 37 per cent of those aged 65 years and under, the researchers report.

Patients in the older age group were also 50 per cent more likely to die within six months of diagnosis than their younger counterparts.

The study, the first to take into account non-cancer causes of death, stage of cancer and fitness of patients, says these disparities cannot be explained by the conscious exclusion of those too ill to benefit from treatment.

Jesme Baird of the Roy Castle Lung Cancer Foundation said: "The decision to operate should be based on how fit and healthy patients are and not on age."

The average age of British patients is 69 years old. Dr Peake said he was certain that low surgery rates in older patients contributed to the UK's historically poor survival rate. Dr Baird agreed. "More elderly patients need to be treated if the UK is to meet the European average," he said.

Dr Peake said he suspected that the root cause of this discrimination lay with a general level of "nihilism" among some doctors who swayed patients against treatment, as well as an inaccessibility of experts to older patients.

"They are seen in elderly medicine departments and not referred," he said.

"This is compounded by a shortage of specialist thoracic surgeons and a concern that operating on additional older patients will adversely affect survival figures."

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