Older people are more likely to die of cancer because they receive less investigation of and treatment for their disease due to "age bias" by the NHS, a major new report warns.
They suffer delays in having their case referred to a specialist, are less likely to undergo radical surgery and have worse outcomes than younger patients, according to the King's Fund health thinktank and Cancer Research UK.
The report highlights under-treatment of older people as a key reason why overall survival from cancer is worse in England than in many other countries, alongside late diagnosis and delays in getting treated.
"Evidence suggesting age bias in access to treatment should be investigated as a priority," it says.
While survival rates are improving generally, the gap between survival from lung cancer in England and certain places abroad has widened in recent years. Survival rates for bowel and ovarian cancer also lag persistently, the study's co-authors found when they analysed international evidence about cancer. "There is substantial evidence that older patients are under-treated and that their outcomes are poorer as a result," say Catherine Foot and Tony Harrison. "Studies indicate that older people are less likely to receive intensive investigation and treatment and are more likely to be admitted as emergencies."
Proportionately fewer senior citizens than younger patients receive extensive surgery to remove tumours, they also discovered. Delays in GPs referring older people to hospital are also a factor, as is some patients' failure to have symptoms checked out quickly enough, they add.
"It is unacceptable that our cancer survival rates lag behind our European neighbours when we spend the equivalent amount on healthcare, and that 15,000 people in the UK over 75 are dying prematurely from cancer each year when compared to the best performing countries worldwide," said the health minister, Paul Burstow, who is responsible for cancer services.
The Department of Health is launching 13 pilot schemes around England to improve survival rates and reduce the excess deaths from cancer among older people by tackling issues raised in the report, in a partnership with the charities Macmillan Cancer Support and Age UK. The initiative would help ensure that the needs of older people with cancer are assessed and met.
The year-long pilots will examine ways of assessing older cancer patients' treatment needs, drawing on approaches used by specialists in geriatric medicine, to ensure more over-70s receive appropriate treatment.
They will also "address any age discrimination in cancer services" by overhauling the training of health professionals to ensure there is proper age equality in cancer care, Macmillan said.
"Overall cancer survival rates are improving but worryingly not as much for older people over 70, who account for half of people with a cancer diagnosis", said Macmillan chief executive Ciaran Devane.
John Baron MP, chair of the all-party parliamentary group on cancer, said: "It is unacceptable that different groups in our society continue to experience significant inequality in cancer screening, treatment, post-treatment care and outcome. It is very wrong that older people are currently under-treated in the NHS. The government needs to address this age bias as a priority."
Poorer women are more likely to die of breast cancer than the better-off, according to a separate report by the National Cancer Intelligence Unit. It pinpoints poorer women not going for screening or to their GP when they develop early symptoms as key reasons for more of them being diagnosed with late stage tumours.
Meanwhile, new research by the Rarer Cancers Foundation shows that over 2,500 patients in England refused access to drugs by their NHS primary care trust finally got them from the government's £200m-a-year Cancer Drugs Fund in the six months after it began last October.
Article from Guardian