title: Understanding the attitudes of the elderly towards enrolment into cancer clinical trials.
abstract: BACKGROUND
  The optimal cancer treatment for an older population is largely unknown because of the low numbers of elderly patients accrued into clinical trials. This project focuses on the attitudes of the elderly about participation in clinical trials to determine if this is one of the barriers to the involvement of this population in clinical trials.
  
  
  METHODS
  The first phase of this study was a self-administered questionnaire mailed to 425 elderly persons with cancer, selected from Princess Margaret Hospital oncology clinics. The second phase consisted of individual semi-structured interviews with cancer patients to assess their attitudes towards cancer, its management and enrolment into cancer clinical trials.
  
  
  RESULTS
  Ninety-four patients responded to the survey giving a response rate of 22.1%. Three quarters of respondents stated that they would be willing to participate in a clinical trial. The factors that most influenced older patients' willingness to participate in a cancer study were recommendations from a cancer doctor and the chance that the study treatment may help them feel better. Seventeen survey responders participated in interviews. Common themes from these interviews included patient-physician communication, the referral process, and the role of age in cancer care decision-making.
  
  
  CONCLUSIONS
  Most elderly people, who responded to this survey, are willing to consider participation in cancer clinical trials however, elderly patients do not appear to actively seek clinical trials and few were informed of the availability of clinical trials. Physician barriers and availability of appropriate clinical trials may play a bigger role in preventing accrual of elderly cancer patients into trials.
authors.affiliation: Princess Margaret Hospital (PMH) and University of Toronto, Toronto, Canada. carol.townsley@uhn.on.ca
authors.forename: Carol A
authors.initials: CA
authors.lastname: Townsley
authors.forename: Kelvin K
authors.initials: KK
authors.lastname: Chan
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Pond
authors.forename: Christine
authors.initials: C
authors.lastname: Marquez
authors.forename: Lillian L
authors.initials: LL
authors.lastname: Siu
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002986:Clinical Trials as Topic; D032882:Comprehension; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D009864:Ontario; D010358:Patient Participation / Q000706:statistics & numerical data; D018579:Patient Selection; D010817:Physician-Patient Relations; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000941:ethics / Q000706:statistics & numerical data*