Access to Care and Prognosis in Elderly With Cancer (INCAPAC Study)

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

450 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-11-30

Study Completion Date

2017-11-30

Brief Summary

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The growing incidence of cancer associated to an aging population represents an epidemiologic reality that requires questioning access to care and prognosis in elderly with cancer, for which disparities have been highlighted. However, generally speaking, studies are limited in that they overlook geriatric-specific factors. The aim of this work was to study sociodemographic, socioeconomic and clinical determinants of access to care (cancer stage, cancer treatment) and prognosis (functional decline, survival) in elderly cancer patients.

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Detailed Description

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The French department of Gironde (1.5 million inhabitants) is covered by cancer registries. In addition, three cohorts were initiated in Gironde on cerebral and functional aging that enrolled subjects aged 65 years and over: the PAQUID study (1988), the 3-City study (1999), and the AMI study (2007). In these cohorts, a large amount of individual data on the participants has been collected longitudinally at different follow-up visits, conducted every two or three years.

Using cancer registries, older subjects with cancer were identified in the cohort studies. Subjects were included if they presented the following: i) aged 65 years and over from one of the three cohorts, ii) alive on January 1st 2005 (common start date for tumor recording) and resident in Gironde, and iii) with a validated cancer diagnosis recorded in one of the cancer registries from January 1st 2005 to December 31st 2014. All tumors for which data is annually sent by cancer registries to the International Agency for Research of Cancer were included: invasive malignant tumors and benign tumors of the central nervous system. As the incidence of skin tumors in older cancer patients is high, they were also included. For patients with multiple tumors, only one was considered: either the first one diagnosed if there were several tumors with a minimum of a 6 months interval between their diagnosis, or the one with the worse prognosis if there were several tumors diagnosed within 6 months.

In order to not consider information concerning patients' characteristics that was too old, subjects with a delay between the last completed cohort follow-up visit before the cancer diagnosis and the diagnosis of cancer equal or superior to 6 years were excluded.

Variables were extracted from cohorts and registries at different times: cohort inclusion, pre-diagnosis visit, cancer diagnosis or registries follow-up.

Conditions

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Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Older patients with cancer

Subjects i) aged 65 years and over from the PAQUID, the 3City or the AMI study; ii) alive on January 1st 2005 (common start date of tumor recording); iii) resident in Gironde; and iv) with a validated cancer diagnosis recorded in one of the cancer registries from January 1st 2005 to December 31st 2014. We included all invasive malignant tumors (including skin tumors) and benign tumors of the central nervous system. For patients with multiple tumors, only one was considered: i) the first one diagnosed if there were several tumors with a minimum of a 6 months interval between their diagnosis, ii) the one with the worse prognosis if there were several tumors diagnosed within less than 6 months.

Any cancer treatment

Intervention Type OTHER

Interventions

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Any cancer treatment

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 65 years
* Alive on January 1st 2005 ( PAQUID or 3-City cohorts) or included in the AMI cohort study
* Cancer diagnosis recorded in one of the cancer registries in Gironde, French department

Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No