Temporal and regional variability in the surgical treatment of cancer among older people.
OBJECTIVE
Numerous studies have documented that older individuals with cancer have been treated less aggressively than younger individuals. We utilized data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program to assess geographic variation in the effects of age on the surgical treatment of cancer and to examine temporal trends in the treatment of older people between 1973 and 1991.


METHODS
Ecological analyses comparing time trends of treatment in nine regions over a 19-year period.


METHODS
Population-based data for nine geographic areas of the United States.


METHODS
Persons with incident cancer of the breast, colon, rectum, lung, ovary, uterus, pancreas, and stomach residing in these regions during the selected years.


RESULTS
After age 64, the percentage of patients treated surgically decreased with increasing age for every cancer site studied. Between 1973 and 1991, the likelihood of receiving surgery for cancers of the uterus, colon, rectum, ovary, and breast increased more rapidly among patients ages 65 years and older than among those under age 65. This relative increase occurred consistently across most geographic areas studied. For cancers of the lung, stomach, and pancreas, the effect of age on the likelihood of receiving surgery did not diminish through the period under study.:


CONCLUSIONS
Although older people remain less likely to receive surgical therapy than younger persons, for some important cancer sites the gap between the treatment of older and younger individuals narrowed from 1973 through 1991.
Farrow
D C
DC
Department of Epidemiology, University of Washington, Seattle, USA.
Hunt
W C
WC
Samet
J M
JM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D018426:SEER Program; D014481:United States