title: Predicting the need for end-of-life care for elderly cancer patients: findings from a Dutch regional cancer registry database.
abstract: Over 80% of all deaths in the Netherlands concern people aged 65 years and older. Elderly patients who have been diagnosed with a life-limiting illness have many unmet healthcare needs in the last phase of their life. For this exploratory population-based study, data from the Eindhoven Cancer Registry were retrospectively analysed to determine possible trends in the number, patient characteristics, treatment and survival of patients aged 65 years and older newly diagnosed with stage IV cancer (n= 9028), a group of elderly in the palliative phase of cancer. During 1996-2006 a substantial increase of 81% in the number of elderly patients newly diagnosed with cancer stage IV was found. Over 70% of these patients received primary cancer treatment, irrespective of serious comorbidity (in 61% of them) and a short life expectancy (most died within 12 months except for those with cancer of the prostate). The vast increase in the number of the elderly who need palliative care contributes to awareness among healthcare professionals about future demand. They enable anticipation and planning sufficient end-of-life care capacity, but also to develop care planning programmes for these older palliative cancer patients. Research needs to be done on aspects of the symptom burden, role of palliative treatment, psychological, social and spiritual needs and end-of-life decision-making. Registration of additional data on these aspects of (palliative) care is suggested.
authors.affiliation: Department for Palliative Care, Comprehensive Cancer Centre South, Eindhoven, the Netherlands. t.olden@ikz.nl
authors.forename: T E
authors.initials: TE
authors.lastname: Olden
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
authors.forename: J P H
authors.initials: JP
authors.lastname: Hamers
authors.forename: S A M
authors.initials: SA
authors.lastname: Van De Schans
authors.forename: J W W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D013727:Terminal Care