Health Equity for Older Adults With Cancer

Tucker-Seeley, Reginald; Wallington, Sherrie Flynt; Canin, Beverly; Tang, Weizhou; McKoy, June M.

doi:10.1200/jco.21.00207

Cited by 21 publications

(20 citation statements)

References 90 publications

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“…Further research is warranted to understand the factors contributing to these health disparities with the goal of promoting health equity 5 . The majority of new cancer diagnoses and cancer deaths occur in older adults, with differential impacts of aging now also recognized as a health disparity 10‐12 . There is a need to learn more about dually vulnerable groups such as people who are both Black and of advanced age.…”

Section: Introductionmentioning

confidence: 99%

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Racial disparities in frailty and geriatric assessment impairments in older adults with cancer in the Deep South: Results from the CARE Registry

Williams

Al‐Obaidi

Harmon

et al. 2022

Cancer

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BACKGROUND: Despite recent advances in cancer, racial disparities in treatment outcomes persist, and their mechanisms are still not fully understood. The objective of this study was to examine racial differences in frailty and geriatric assessment impairments in an unselected cohort of older adults with newly diagnosed gastrointestinal (GI) malignancies. METHODS: This study used data from the Cancer and Aging Resilience Evaluation Registry, a prospective cohort study that enrolled older adults (≥60 years) with GI malignancies who were presenting for their initial consultation. Participants who had a geriatric assessment completed before chemotherapy initiation and self-reported as either White or Black were included. Frailty was defined with a frailty index based on the deficit accumulation method. The differences in the prevalence and adjusted odds ratios for frailty and geriatric assessment impairments between Black and White participants were examined. RESULTS: Of the 710 eligible patients who were seen, 553 consented with sufficient data for analyses. The mean age at enrollment was 70 ± 7.1 years, 58% were male, and 23% were Black. Primary cancer diagnoses included colorectal cancer (32%), pancreatic cancer (27%), and hepatobiliary cancer (18%). Black participants were more likely to be frail (50.0% vs 32.7%; P < .001) and report limitations in activities of daily living (27.3% vs 14.1%; P = .001), instrumental activities of daily living (64.8% vs 47.3%; P = .002), and walking 1 block (62.5% vs 48.2%; P = .004). These associations persisted even after adjustments for age, sex, education, cancer type, cancer stage, and comorbidity. CONCLUSIONS: Black participants were frailer and reported more limitations in function in comparison with White participants. These findings may partially explain disparities in cancer outcomes and warrant further examination.

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Section: Introductionmentioning

confidence: 99%

“…5 The majority of new cancer diagnoses and cancer deaths occur in older adults, with differential impacts of aging now also recognized as a health disparity. [10][11][12] There is a need to learn more about dually vulnerable groups such as people who are both Black and of advanced age.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in frailty and geriatric assessment impairments in older adults with cancer in the Deep South: Results from the CARE Registry

Williams

Al‐Obaidi

Harmon

et al. 2022

Cancer

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“…Given the increasing diversity of the aging population, it is critical to understand health disparities across the cancer continuum 74 to improve equitable healthy aging of older survivors. Sociodemographic subgroups can experience cancer differently, with many people of color and those with lower socioeconomic status having higher prevalence, incidence, and mortality and lower rates of cancer screening, survivorship, and quality of life 75 .…”

Section: Priority Research Areas In Cancer and Agingmentioning

confidence: 99%

New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control

Kobayashi

Westrick

Doshi

et al. 2022

Cancer

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BACKGROUND:The global population of older cancer survivors is growing. However, the intersections of aging-related health risks across the cancer control continuum are poorly understood, limiting the integration of aging into cancer control research and practice. The objective of this study was to review the state of science and provide future directions to improve the quality of evidence in 6 priority research areas in cancer and aging. METHODS: The authors identified priority research areas in cancer and aging through an evidencebased Research Jam process involving 32 investigators and trainees from multiple disciplines and research centers in aging and cancer; then, they conducted a narrative review of the state of the science and future directions to improve the quality of evidence in these research areas. Priority research areas were defined as those in which gaps in scientific evidence or clinical practice limit the health and well-being of older adults with cancer. RESULTS: Six priority research areas were identified: cognitive and physical functional outcomes of older cancer survivors, sampling issues in studies of older cancer survivors, risk and resilience across the lifespan, caregiver support and well-being, quality of care for older patients with cancer, and health disparities. Evidence in these areas could be improved through the incorporation of bias reduction techniques into longitudinal studies of older cancer survivors, novel data linkage, and improved representation of older adults in cancer research. CONCLUSIONS: The priority research areas and methodologies identified here may be used to guide interdisciplinary research and improve the quality of evidence on cancer and aging.

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“…An increased workforce in geriatric oncology could drive the implementation of age-friendly health systems in which individualized assessment of the 4Ms (what Matters to the patients and their family, Medications, Mentation and Mobility) could be provided to each patient to guide individualized plans of care [134]. Finally, health equity requires that we ensure that minority groups are adequately considered among older adults, for example, equally included in clinical trials [2,135] (Fig. 5).…”

Section: Health Disparities Among Older Cancer Patientsmentioning

confidence: 99%

Ageing and cancer: a research gap to fill

2022

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The complex mechanisms of ageing biology are increasingly understood. Interventions to reduce or delay ageing-associated diseases are emerging. Cancer is one of the diseases promoted by tissue ageing. A clockwise mutational signature is identified in many tumours. Ageing might be a modifiable cancer risk factor. To reduce the incidence of ageing-related cancer and to detect the disease at earlier stages, we need to understand better the links between ageing and tumours. When a cancer is established, geriatric assessment and measures of biological age might help to generate evidencebased therapeutic recommendations. In this approach, patients and caregivers would include the respective weight to give to the quality of life and survival in the therapeutic choices. The increasing burden of cancer in older patients requires new generations of researchers and geriatric oncologists to be trained, to properly address disease complexity in a multidisciplinary manner, and to reduce health inequities in this population of patients. In this review, we propose a series of research challenges to tackle in the next few years to better prevent, detect and treat cancer in older patients while preserving their quality of life.

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Health Equity for Older Adults With Cancer

Cited by 21 publications

References 90 publications

Racial disparities in frailty and geriatric assessment impairments in older adults with cancer in the Deep South: Results from the CARE Registry

Racial disparities in frailty and geriatric assessment impairments in older adults with cancer in the Deep South: Results from the CARE Registry

New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control

Ageing and cancer: a research gap to fill

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