I enjoyed reading the article by Marko Simunovic and colleagues on waiting times for cancer surgery.1 I was particularly intrigued by the fact that there were no age-related differences in median waiting times from referral to surgery. This is somewhat surprising, given the growing body of literature suggesting that older adults with cancer receive less aggressive diagnostic workups and treatments than younger adults.2,3,4,5,6,7
The investigators analyzed all tumour types together for patients aged 50 years or less, 51 to 65 years and 66 years or more. Given that they demonstrated differences in waiting times across cancer types, and given that some cancers are more common than others in different age groups, this analysis may mask true age-related differences in waiting times. Did the authors examine age-related waiting times separately for each tumour type?
References
- 1.Simunovic M, Gagliardi A, McCready D, Coates A, Levine M, DePetrillo D. A snapshot of waiting times for cancer surgery provided by surgeons affiliated with regional cancer centres in Ontario. CMAJ 2001;165(4):421-5. [PMC free article] [PubMed]
- 2.Alibhai SMH, Krahn MD, Cohen MM, Fleshner NE, Naglie G. Older patients receive less aggressive treatment for clinically localized prostate cancer [abstract]. Clin Invest Med 2000; 23 (5):332.
- 3.Position paper by the UKCCCR elderly cancer patients in clinical trials working group. Br J Cancer 2000;82:1-3. [DOI] [PMC free article] [PubMed]
- 4.Guadagnoli E, Weitberg A, Mor V, Silliman RA, Glicksman AS, Cummings FJ. The influence of patient age on the diagnosis and treatment of lung and colorectal cancer. Arch Intern Med 1990;150(7):1485-90. [PubMed]
- 5.Silliman RA, Guadagnoli E, Weitberg AB, Mor V. Age as a predictor of diagnostic and initial treatment intensity in newly diagnosed breast cancer patients. J Gerontol 1989;44(2):M46-50. [DOI] [PubMed]
- 6.Silliman RA, Dukes KA, Sullivan LM, Kaplan SH. Breast cancer care in older women. Cancer 1998;83:706-11. [PubMed]
- 7.Yancik R, Ries LG. Cancer in the aged. An epidemiologic perspective on treatment issues. Cancer 1991;68(11 Suppl):2502-10. [DOI] [PubMed]