Access to Care and Prognosis in Elderly With Cancer (INCAPAC Study)
Condition: Cancer
Study type: Observational

Summary: 
      The growing incidence of cancer associated to an aging population represents an epidemiologic
      reality that requires questioning access to care and prognosis in elderly with cancer, for
      which disparities have been highlighted. However, generally speaking, studies are limited in
      that they overlook geriatric-specific factors. The aim of this work was to study
      sociodemographic, socioeconomic and clinical determinants of access to care (cancer stage,
      cancer treatment) and prognosis (functional decline, survival) in elderly cancer patients.
    

Detailed description: 
      The French department of Gironde (1.5 million inhabitants) is covered by cancer registries.
      In addition, three cohorts were initiated in Gironde on cerebral and functional aging that
      enrolled subjects aged 65 years and over: the PAQUID study (1988), the 3-City study (1999),
      and the AMI study (2007). In these cohorts, a large amount of individual data on the
      participants has been collected longitudinally at different follow-up visits, conducted every
      two or three years.

      Using cancer registries, older subjects with cancer were identified in the cohort studies.
      Subjects were included if they presented the following: i) aged 65 years and over from one of
      the three cohorts, ii) alive on January 1st 2005 (common start date for tumor recording) and
      resident in Gironde, and iii) with a validated cancer diagnosis recorded in one of the cancer
      registries from January 1st 2005 to December 31st 2014. All tumors for which data is annually
      sent by cancer registries to the International Agency for Research of Cancer were included:
      invasive malignant tumors and benign tumors of the central nervous system. As the incidence
      of skin tumors in older cancer patients is high, they were also included. For patients with
      multiple tumors, only one was considered: either the first one diagnosed if there were
      several tumors with a minimum of a 6 months interval between their diagnosis, or the one with
      the worse prognosis if there were several tumors diagnosed within 6 months.

      In order to not consider information concerning patients' characteristics that was too old,
      subjects with a delay between the last completed cohort follow-up visit before the cancer
      diagnosis and the diagnosis of cancer equal or superior to 6 years were excluded.

      Variables were extracted from cohorts and registries at different times: cohort inclusion,
      pre-diagnosis visit, cancer diagnosis or registries follow-up.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Subjects aged 65 and over with a diagnosis of cancer recorded in one of the cancer
        registries in Gironde, French department.
      
Keywords: Elderly; Cancer; Cohort study; Cancer registry; Access to care; Cancer stage; Cancer treatment; Prognosis; Functional decline; Survival