Is there evidence of age bias in breast cancer health care professionals’ treatment of older patients?

Neal, Daisy; Morgan, Jenna; Kenny, Ross; Ormerod, Thomas C.; Reed, Malcolm

doi:10.1016/j.ejso.2022.07.003

Cited by 10 publications

(6 citation statements)

References 45 publications

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“…In addition, Greener [16] noted that individuals aged 80 years and older were more likely to have late diagnosis of breast cancer (23%) than women 15–59 years old (16%). Further corroborating data from Neal et al [15 ▪ ], it was noted that surgical intervention was significantly less likely to occur in older individuals [16]. These findings are in keeping with previously published data, and again demonstrate structural ageism [17,18].…”

Section: The Effects Of Ageism On Specific Cancerssupporting

confidence: 89%

“…When discussing treatment recommendations, healthcare providers were significantly less likely to recommend surgical management of breast cancer in older patients, even when compared with identically matched younger patients. Furthermore, the authors found that a significant proportion of healthcare providers felt that older patients would not want comprehensive information about likely treatment options, and that many assumed that older patients were more afraid, and less able to comprehensively ‘cope’ with information about prognosis [15 ▪ ].…”

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

“…In their analysis of breast cancer clinicians, Neal et al . [15 ▪ ] used a mixed methods analysis to ascertain practitioner's perspectives on older women with breast cancer. The authors found that 90% of breast cancer healthcare practitioners showed a moderate ‘antiold’ implicit association, indicating a held correlation between older women and negative attributes [15 ▪ ].…”

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

“…[15 ▪ ] used a mixed methods analysis to ascertain practitioner's perspectives on older women with breast cancer. The authors found that 90% of breast cancer healthcare practitioners showed a moderate ‘antiold’ implicit association, indicating a held correlation between older women and negative attributes [15 ▪ ]. When discussing treatment recommendations, healthcare providers were significantly less likely to recommend surgical management of breast cancer in older patients, even when compared with identically matched younger patients.…”

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

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The impact of ageism in the care of older adults with cancer

Krasovitsky

Porter²,

Tuch

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review This review summarizes recent research on the impact of ageism in older adults with cancer and how society can best address the issue. Despite older individuals representing the vast majority of those with cancer, with a dramatic increase in incidence anticipated in the coming decades, ageism remains an under-recognized and extremely detrimental phenomenon in cancer care. Recent findings We examine the associations between ageism and health, and highlight the consequences of higher mortality, a deterioration in mental and physical health, worse functional status and increased comorbidity burden. We then discuss the oncologic-specific impacts of ageism, including lower rates of cancer screening, decreased histological confirmation of cancer, decreased surgical intervention and systemic therapy prescription and poorer survivorship experience. To conclude, we illustrate the opportunities within oncologic systems of care to engage with, and dismantle, the damaging effects of ageism, namely policy and legislation, education and intergenerational contact. Summary Despite recognition of the numerous negative sequelae of ageism, there remains a paucity of literature regarding the intersection between ageism and cancer. Our piece summarizes the key developments in this field, but further evaluation is desperately required.

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Section: The Effects Of Ageism On Specific Cancerssupporting

confidence: 89%

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

Section: The Effects Of Ageism On Specific Cancersmentioning

confidence: 99%

See 2 more Smart Citations

The impact of ageism in the care of older adults with cancer

Krasovitsky

Porter²,

Tuch

2023

Current Opinion in Supportive &Amp; Palliative Care

View full text Add to dashboard Cite

show abstract

“…While de-escalation practices are typically benevolent recommendations in response to patient comorbidities and frailty, it is also possible that age bias partially accounts for the significantly lower levels of curative therapy delivered to patients ≥80 years old with early stage breast cancer. Ageism in healthcare has recently been studied extensively, and specifically linked to de-escalation practices in local treatment of early stage breast cancer [ 26 , 27 ]. With the ever-increasing life expectancy of our population, clinicians must balance the desire to avoid morbidity from cancer treatment now with the real possibility that an elderly patient will be living with an untreated breast cancer for many months if not years to come.…”

Section: Discussionmentioning

confidence: 99%