Wednesday, April 29, 2009
Sadrivaan A and B (The Hilton Istanbul Hotel )
Nigel Bruce
The University of Liverpool , The UK, United Kingdom
Background
Cancer is a disease of the elderly: about 50% deaths occur in the over75s, and 38% of cancers are diagnosed in this age group. ‘Our Healthier Nation’ sets out targets of decreasing cancer mortality in England which excludes over 75s without giving explicit reasons. Objectives
To explore the reasons why mortality rates are decreasing less and survival rates are lower in the elderly as compared to the USA. Methods
Age-specific mortality rates in England from all cancers and breast, colorectal, lung and prostate for the under65,65-74,75-84 and 85 and over age-groups between 1992-2004 and incidence rates for the 65-74, 75-84 and 85 and over between 1995-2003 were calculated using data provided by ONS. Percentage changes in mortality and incidence rates for the combined years from 1995-97to2002-2004 were calculated for England and mortality rates were compared with the USA for the 65-74 and 75-84 year age groups. Survival rates for the four cancer sites were calculated and compared with the USA. Results
Cancer mortality rates for males in England during 1995-97vs1998-01 and 1995-97vs2002-04 decreased -8.9%and-14.8% for the 65-74and -4.9% and -4.7% for the 75-84 age-groups respectively. In females there was a decrease of -6.2%and-10.5% for the 65-74, and -1.5% and an increase of +2.6% for the 75-84 for the two time periods respectively. In comparison to the USA there was a widening gap between 65-74 and 75-84 in England for all sites studied. Percentage changes in incidence rates were generally higher in the 65-74 and there were far better survival rates in the USA in all age groups for the sites studied. Conclusion
Exclusion of elderly from cancer targets would mean little or no prevention or health promotion programming. This is clearly an inequality with older age groups they should be given serious attention and included in the cancer targets as in the USA.
Learning Objectives: Participants would be able to understand/learn/analyze that:
- How cancer inequality might be able to affect prevention and health promotion interventions focussed on elderly.
- There is explicit evidence which has shown clear improvement in mortality and survival rates in elderly as opposed to the hypothesis that there is no or little improvement in cancer prevention or treatment in elderly.
- How exclusion of elderly from the national cancer targets/policy would exclude them from clinical trials and prevention programs.
Sub-Theme: Social determinants of health and disease
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