ArticleInternational journal of radiation oncology, biology, physics2017
Influence of Age on Guideline-Concordant Cancer Care for Elderly Patients in the United States.
Article in International journal of radiation oncology, biology, physics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Clinicians' attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature.Implementation science : IS · 2020Pooled it
- Evaluation of a National Comprehensive Cancer Network Guidelines-Based Decision Support Tool in Patients With Non-Small Cell Lung Cancer: A Nonrandomized Clinical Trial.JAMA network open · 2020Trial
- Conceptualizing surgical ageism to address age-based discrimination.Updates in surgery · 2026Review
- Surgery Versus Radiation for Stage 1A NSCLC in Nonagenarians: 20 Years of Data, Decisions, and Outcomes.Annals of surgical oncology · 2026Article
- Associations Between G8 Geriatric Screening Score, Charlson Comorbidity Index, AI-Based Age Phenotype, and Overall Survival in Older Adults With Stage I-II Non-Small Cell Lung Cancer.International journal of radiation oncology, biology, physics · 2025Article
- Therapeutic Management in Elderly Male Breast Cancer Patients: A Scoping Review.Current oncology reports · 2025Article
- Review
- Geographic and socioeconomic variation in treatment of elderly prostate cancer patients in Norway - a national register-based study.Research in health services & regions · 2024Article
- Bifidobacterium modulation of tumor immunotherapy and its mechanism.Cancer immunology, immunotherapy : CII · 2024Review
- Breast cancer histopathology, classification and clinical management: Current perspectives.Bioinformation · 2024Article
- Adapting, implementing and evaluating a navigation intervention for older people with cancer and their family caregivers in six countries in Europe: the Horizon Europe-funded EU NAVIGATE project.Palliative care and social practice · 2024Article
- Review
- Cancer statistics in Chinese older people, 2022: current burden, time trends, and comparisons with the US, Japan, and the Republic of Korea.Science China. Life sciences · 2023Article
- Frailty-the missing constraint in radiotherapy treatment planning for older adults.Aging clinical and experimental research · 2022Review
- Accuracy of tumor registry versus pharmacy dispensings for breast cancer adjuvant endocrine therapy.Cancer causes & control : CCC · 2022Article
- Stigma May Exacerbate Disproportionately Low Guideline-Concordant Treatment Rates for Patients With Advanced-Stage Lung Cancer in the United States.JTO clinical and research reports · 2022Article
- Article
- Increasing disparities in the proportions of active treatment and 5-year overall survival over time by age groups among older patients with gastric cancer in Korea.Frontiers in public health · 2022Article
- Toxicity and antitumor activity of novel agents in elderly patients with cancer included in phase 1 studies.Investigational new drugs · 2021Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo examine the frequency of guideline-concordant cancer care in elderly patients, including "older" elderly (age ≥80 years). METHODS AND MATERIALS: Using the Surveillance, Epidemiology and End Results-Medicare dataset in patients aged ≥66 years diagnosed with nonmetastatic breast cancer (n=55,094), non-small cell lung (NSCLC) (n=36,203), or prostate cancer (n=86,544) from 2006 to 2011, chemotherapy, surgery, and radiation (RT) treatments were identified using claims. Pearson χ
resultsOlder patients were less likely to receive guideline-concordant curative treatment: in stage III breast cancer, receipt of postmastectomy RT (70%, 46%, and 21% in patients aged 66-79, 80-89, and ≥90 years, respectively; P<.0001); in stage I NSCLC, RT or surgery (89%, 80%, and 64% in age 66-79, 80-89, and ≥90 years; P<.0001); in stage III NSCLC, RT or surgery plus chemotherapy (79%, 58%, and 27% in age 66-79, 80-89, and ≥90 years; P<.0001); and in intermediate/high-risk prostate cancer, RT or prostatectomy (projected life expectancy >10 years: 85% and 82% in age 66-69 and 70-75 years; and ≤10 years: 70%, 42%, and 9% in age 76-79, 80-89, and ≥90 years; P<.0001). However, older patients were more likely to receive guideline-concordant de-intensified treatment: in stage I to II node-negative breast cancer, hypofractionated postlumpectomy RT (9%, 16%, and 23% in age 66-79, 80-89, and ≥90 years; P<.0001); in stage I estrogen receptor-positive breast cancer, observation after lumpectomy (12%, 42%, and 84% in age 66-79, 80-89, and ≥90 years; P<.0001); in stage I NSCLC, stereotactic body RT instead of surgery (7%, 16%, and 25% in age 66-79, 80-89, and ≥90 years; P<.0001); and in lower-risk prostate cancer, no active treatment (25%, 54%, and 68% in age 66-79, 80-89, and ≥90 years; P<.0001).
conclusionActual treatment of older elderly cancer patients frequently diverged from guidelines, especially in curative treatment of advanced disease. Results suggest a need for better metrics than existing guidelines alone to evaluate quality and appropriateness of care in this population.
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Registered trials
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