information of older patients with cancer is crucial to ensure optimal care.
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to compare older patients with and without cancer regarding their preferences about medical information, decision-making and surrogate designation.
an intention-to-act questionnaire was completed by patients ≥70 y enroled in the ELderly CAncer PAtients cohort between January and June 2013 and by patients in the same age group enroled in a cross-sectional survey conducted in 2005 in acute geriatric wards.
Henri-Mondor Teaching Hospital in the Paris conurbation, France.
the group with cancer had 133 patients [mean age, 79.6 ± 6.5 y; 54.9% women]. The main tumour sites were colorectal [24.1%], breast [23.3%] and prostate [15.8%]; 34.8% had metastases. All these patients wanted full information, 74.2% wanted to participate in decisions about their care, 87.2% would designate a family member to serve as a surrogate in life-threatening situations and 15% had already designated a surrogate. Compared to patients without cancer, those with cancer more often wanted to receive information in a life-threatening situation [93.6% versus 79.2%; P< 0.001]. Factors independently associated with patients wanting their informed consent to be obtained for all interventions were having children [adjusted odds ratio (aOR), 2.13; 95% confidence interval, 1.24; 3.66; P = 0.006], higher Mini Mental State Examination score [aORper point, 1.09; 1.02; 1.17], younger age in the group without cancer [aOR>82 y vs. ≤82 y, 0.50; 0.29-0.88] and being cancer-free [≤82 y, aOR, 0.30; 0.14-0.63; >82 y, aOR, 0.41; 0.17-0.97].
older patients with cancer expressed a strong preference for receiving information and participating in decisions about their care.
Age and ageing. 2017 Jan 18 [Epub ahead of print]
Elena Paillaud, Florence Canoui-Poitrine, Gwenaelle Varnier, Narges Anfasi-Ebadi, Ester Guery, Olivier Saint-Jean, Mathilde Gisselbrecht, Thomas Aparicio, Sylvie Bastuji-Garin, Marie Laurent, Philippe Caillet
Department of Internal and Geriatric Medicine, Assistance Publique - Hopitaux de Paris, Henri-Mondor Hospital, Paris, Île-de-France, France ., CEpiA (Clinical Epidemiology and Ageing), University Paris-Est Créteil (UPEC) , EA 7376- IMRB, Creteil, France., Department of Internal and Geriatric Medicine, Assistance Publique - Hopitaux de Paris, Henri-Mondor Hospital, Paris, Île-de-France, France., Geriatrics Department, Assistance Publique - Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, Île-de-France, France., Gastroenterology and Digestive Oncology Department, Assistance Publique - Hopitaux de Paris, Avicenne hospital, Bobigny, Île-de-France, France.