Prevalence of cancer and management in elderly nursing home residents. A descriptive study in 45 French nursing homes

Abstract

This study aimed to determine cancer prevalence occurring after the age of 75 in 45 French nursing homes (NH), as well as residents’ characteristics and parameters associated with cancer‐specific management. Descriptive retrospective study including 214 residents (mean age, 89.7 years) with cancer diagnosed after age 75. The studied parameters were sociodemographic, functional, nutritional and cognitive data; comorbidity assessment; date of tumoral diagnosis; cancer type; tumoral stage; treatment plan; multidisciplinary staff decision and oncologic follow‐up. Our results showed that cancer prevalence in NH was 8.4 ± 1.1%, diagnosed before admission in 63% of cases. The most common tumoral sites were skin (26%), digestive tract and breast (18% for both); 12% had metastasis. Cognitive impairment was the most common comorbidity (42%), and 44% of the residents were highly dependent. Multivariate analysis showed that therapeutic decisions were associated with age. Older patients had less staging exploration (odd ratios [ORs], 0.90, 95% confidence interval [CI], 0.85–0.97) and underwent less cancer‐specific treatment (ORs, 0.92; 95%CI, 0.86–0.99). Oncologic follow‐up was more frequent in younger patients (ORs, 0.90; 95%CI, 0.81–0.99) and those with recent diagnosis (ORs, 0.37; 95%CI, 0.23–0.61). This study identified factors associated with substandard neoplastic management in elderly NH residents. It highlights needs for information, education and training in cancer detection to improve cancer consideration and care in NH.

Disparities in the management of cutaneous malignant melanoma. A population‐based high‐resolution study

“…In agreement with several other studies that report frequent omission of standard care in elderly cancer patients (Blakely, Comissiong, Vezeridis, & Miner, ; Guevara et al, ; Liuu et al, ; Livingstone et al, ; Murtha et al, ), we found that those aged ≥70 years were less likely to undergo SLNB. Performing SLNB in the head and neck region can be technically demanding and has been associated with higher false‐negative rates (Tanis, Nieweg, Brekel, & Balm, ).…”

Cultural and Ethical Barriers to Cancer Treatment in Nursing Homes and Educational Strategies: A Scoping Review

“…This category includes a total of 12 studies distributed in four subcategories: patient profiles, cancer management in nursing homes, oncological treatment outcomes, and shared medical decisions [ 17 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

“…Five studies explored the particularities of nursing home residents with cancer and the risk factors for long-term care use [ 22 , 23 , 24 , 25 , 26 , 27 ].…”

“…Staging information was available in only 59.8% of cases, and reports of a multidisciplinary discussion in 34.1%. Exactly 50.0% of subjects were moderately dependent and 43.5% were highly dependent based on a French validated geriatric scale for functional abilities, Autonomie Gérontologique Groupes Iso-Ressources (AGGIR) [ 25 ].…”

“…When admitted in skilled nursing homes, LBM continuation was greater compared to that in home hospices (RR 1. 25 [67]. The SHELTER study assessed 1-year incidence and factors related to deprescribing in nursing home residents with polypharmacy in Europe.…”