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Age
Bias Undermines Treatment of Breast Cancer By
Megan Rauscher Reuters,
September
1, 2003 NEW
YORK (Reuters Health) - Older women with breast cancer (news
- web
sites) are being denied lifesaving treatment for breast cancer solely
because of their age, results of a study of some 480 women suggest. In
the study, women over age 50 with early stage breast cancer were
significantly less likely to be given "adjuvant" chemotherapy --
that is, in addition to surgery and other treatments -- researchers from
Ohio State University in Columbus report in the journal Cancer. The
finding fuels the belief that age bias contributes to undertreatment of
older women with breast cancer. A
number of past studies have already shown that older women are less likely
to be treated with adjuvant chemotherapy, Dr. Charles L. Shapiro and
colleagues say. But until now it hasn't been clear what impact a woman's
age has on the decision to use or withhold adjuvant chemotherapy. They
theorized that taking into account "all of the relevant factors"
that go into the decision to use chemotherapy -- including the size of the
tumor, whether it responds to anti-estrogen therapy or not, whether the
disease has spread to the lymph nodes, and underlying health problems --
older age would be a less important factor in the decision to use adjuvant
chemotherapy. "To
our surprise, we found the opposite was true," Shapiro told Reuters
Health. "Controlling for all the relevant factors, older age becomes
a more important factor, with older women less likely to get
chemotherapy," he said. Women
older than 65 with tumors that do not respond to estrogen, so-called
ER-negative tumors, were about seven times less likely to be treated with
chemotherapy than women younger than 50. This worries Shapiro, because
these women do not benefit from estrogen therapy. "For them,
chemotherapy is the only option," he said. Women
with ER-positive breast cancers between the ages of 50 and 65 were six
times less likely to be offered chemotherapy and those over 65 were 62
times less likely to receive it than women younger than 50. "Over
the next 25 years, doctors and women will increasingly face this decision,
as the population of early stage breast cancer patients over age 65 will
increase," Shapiro told Reuters Health. "Hopefully,
this work will stimulate larger studies that examine the attitudes and
preferences of older women and their physicians with respect to the use of
adjuvant chemotherapy," he added. Copyright
© 2002 Global Action on Aging
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