Few Cancer Services Provided To Nursing Home Residents

Main Category: Cancer / Oncology
Also Included In: Seniors / Aging
Article Date: 27 Dec 2007 - 0:00 PDT

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Elderly nursing home residents receive relatively few cancer care services, including screening, surgical treatment, or hospice care.

Few studies have examined cancer treatment and care among elderly patients residing in nursing homes. Yet as the U.S. population ages, more people will move into nursing homes, many of whom will later be diagnosed with cancer. Cancer risk increases as people age.

Cathy Bradley, Ph.D., of the Virginia Commonwealth University Massey Cancer Center in Richmond and colleagues assessed the cancer care received by elderly nursing home residents who were insured by Medicaid. Using data from the Michigan Tumor Registry and Medicare records, they identified 1,907 nursing home residents diagnosed with cancer. They analyzed the patient data by cancer stage at diagnosis, type of cancer, survival time, and whether the patient received surgery or hospice care, as well as other variables.

Sixty-two percent of the nursing home residents with cancer had late or unstaged disease when they were diagnosed, and almost half died within three months of diagnosis. Among patients with late stage cancer, only 28 percent received hospice care. Patients aged 71 to 75 were three times more likely to have surgery than patients aged 86 and older.

"An aging population, coupled with trends in cancer diagnosis and treatment, will shift more cancer care…to nursing homes and make investigations into the care of nursing home cancer patients particularly relevant. At present, nursing homes may be unequipped to recognize and care for their residents with cancer," the authors write.

In an accompanying editorial, Noreen Aziz, M.D., Ph.D., and Keith Bellizzi, Ph.D., of the National Cancer Institute in Bethesda, Md., describe the essential components of cancer care, which include treatment, follow-up care, and palliative care. They also discuss the importance of further studies on the cancer care needs of this unique population of elderly nursing home residents.

"Optimal palliative care will often require multidisciplinary approaches and treatment plans made in accordance with the wishes of, and in partnership with, the patient and family, with a goal of decreasing morbidity and a focus on quality of life," the editorialists write.

"Absence of Cancer Diagnosis and Treatment in Elderly Medicaid-Insured Nursing Home Residents"
Cathy J. Bradley, Jan P. Clement, Chunchieh Lin
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djm271
Click here to view abstract online

Andrea Widener
Journal of the National Cancer Institute