Treating Colorectal Cancer in the Elderly
Is there a treatment-related survival benefit for older patients with metastatic colorectal cancer?
Treating older patients with metastatic cancer has become a topic of great interest. In addition to quality of life concerns, there are also other considerations, such as the cost of treatment, survival rates, and overall risks versus benefits.
Researchers from the University of Colorado Cancer Center and Colorado School of Public Health used Surveillance, Epidemiology, and End Results-Medicare data for patients diagnosed with metastatic colon (N=16,117) or rectal cancer (N=4008) between 2000 and 2009. They estimated the adjusted percentage of patients who received chemotherapy/targeted therapies and identified treatment costs.
The researchers found that there was a gain in overall survival of about 8 months in patients aged 65-74. However, this same benefit was not evident in patients older than age 75 despite the increase in the number of these patients being treated; the percentage of these older patients receiving three or more treatments increased from 2% to 53%.
During the 10-year study period, treatment costs increased 32% to reach an estimated $2.2 billion annually. However, median survival for these patients increased by only 1 month. Patients’ costs also increased; patients paid approximately $16,000 in out-of-pocket costs for care in 2009, compared with $11,000 in 2000. The researchers concluded that multi-agent regimens may not be of high value in terms of survival and costs for older patients with metastatic colorectal cancer.
Bradley CJ, Yabroff KR, Warren JL, et al. Trends in the treatment of metastatic colon and rectal cancer in elderly patients [published online ahead of print February 19, 2016]. Med Care.