Age and sex-based differences in therapy preferences among patients with cancer: evidence from a novel therapy preference scale.

Background: Patients' preferences are crucial to formulating personalised treatment plans. We developed a self-reported questionnaire, therapy preference scale (TPS), to examine treatment preferences of patients with cancer. Methods: TPS has 30 questions: 19 on patients' preferences on safety, quality of life and treatment effectiveness, 8 questions on the importance of various treatment characteristics and 3 on patients' preferred intent of therapy, expenses and life expectancy gain. We recruited 300 adults >18 years with a cancer diagnosis and categorised them into 4 age-by-sex groups (younger men <60 years, older men ≥60 years, younger women< 60 years, older women ≥60 years). Kruskal-Wallis non-parametric ANOVA method was used to compare responses among four groups. Results: Older women, compared to other groups, were more likely to value maintenance of cognitive function and ability to perform daily activities. Older women were more likely to risk having a shorter life expectancy rather than facing the risk of long-term cognitive impairments. Younger men and women were more likely to accept more effective treatment, even if it caused significant pain. A higher percentage of younger men, compared to other groups, valued maintaining sex life. Older men and women were more likely to prefer oral pills over intravenous therapy. Conclusion: Patient preferences may vary based on age and sex, with older women prioritising cognitive and physical function independence more frequently, whereas younger men and women are willing to pursue more effective treatment options even with a greater risk of significant pain. TPS can elicit detailed preferences of an individual patient to facilitate shared decision-making with their oncologists.