Cancer Survival Gains Not the Same for All Groups

Cancer survival improved more for younger patients than older patients

(RxWiki News) Cancer patients are winning the battle against the disease like never before, but age and race may play a role in determining survival odds.

Recent advances in cancer diagnosis and treatment have improved survival for patients with different types of cancer, but improvements were better for younger patients, a new study found.

Lead study author Wei Zheng, MD, PhD, of the Vanderbilt-Ingram Cancer Center in Nashville, TN, and colleagues studied data collected between 1990 and 2010 for more than 1 million cancer patients. This study included patients with cancers of the colon and rectum, breast, prostate, lungs, liver, pancreas or ovaries. These types of cancer accounted for 60 percent of US cancer deaths in 2014, Dr. Zheng and team noted.

All age groups showed improved survival for all these types of cancer — except for ovarian cancer — over those two decades. However, patients older than 75 had smaller improvements than younger patients, Dr. Zheng and team found.

Doctors often choose less aggressive treatments for older patients regardless of cancer stage, these researchers said. The elderly are also less likely to take part in clinical trials.

"There is concern that treatments that may be effective in younger patients in clinical trials may be more toxic and less effective in the elderly," Dr. Zheng and team wrote. "Our findings demonstrate that age-associated disparities exist and underscore the importance of conducting clinical trials and postmarketing studies to identify optimal treatment regimens, necessary dose adjustments, and distinct toxic effects for elderly patients with cancer. This is particularly pressing because this population constitutes the fastest growing subpopulation of cancer patients in the United States."

Dr. Zheng and colleagues also found that blacks had poorer survival than whites for all cancers except prostate cancer. Improved prostate cancer survival may be due in part to recent education campaigns designed to raise cancer awareness among blacks, the research team said.

Future cancer research must include minorities and older patients in greater numbers to improve cancer treatment and survival for all patients, Dr. Zheng and team said.

"Our data suggest that age- and race-related differences in survival improvements over time may be explained, at least in part, by differences in cancer care across these subpopulations," Dr. Zheng and team wrote. "By demonstrating these disparities, we have taken an initial step toward acknowledging the possibility of differential care and/or responses to new therapies for different patients."

This study was published Feb. 19 in JAMA Oncology.

The National Institutes of Health, Ingram Professorship and Anne Potter Wilson Chair grants and the Vanderbilt International Scholarship Program funded this research. The authors disclosed no conflicts of interest.

Review Date: 
February 19, 2015