Aim:
To review the current radiotherapy utilisation (RTU) rate for patients as a function of increasing age and particularly, in patients older than 80 years of age
Background
Larger non-age specific RTU studies have demonstrated that the actual RTU rates are below the optimal rates. The optimal utilisation rates for the geriatric oncology cohort of patients have not yet been determined.
Methods
Data from NSW Central Cancer Registry for the period 2009-11 were linked to the NSW Radiotherapy Dataset covering the period from 2009 to 2012. Actual RTU rates were calculated for patients aged <80 years and patients aged 80+ years. RTU was defined as receiving at least one single course of radiotherapy within one year of the cancer diagnosis.
Results
During the study period 110,645 patients were diagnosed with cancer, of whom 27,721 patients received at least one course of radiotherapy during the first year after diagnosis. The overall RTU rate was 25% versus 14% for patients aged 80 years and above. RTU rates for patients aged less than 80 years and diagnosed with lung, breast, rectal and prostate cancers were 45%, 66%, 39% and 24%, respectively compared to 26%, 23%, 24% and 13%, respectively for patients aged 80+ years (p<0.001). The RTU rates for patients living 100+km from the nearest radiotherapy facility and aged less 80 years for lung, breast, rectal and prostate cancers were 39%, 55%, 44% and 17%, respectively compared to 19%, 16%, 18% and 7% for patients aged 80+ years (p<0.001). RTU also decreases in patients living in disadvantaged socioeconomic areas. Prostate cancer patients were an exception to the above statements showing a decrease in RTU for patients living in higher SES areas.
Conclusion
Radiotherapy utilisation decreases with increasing age and increasing distance from the nearest radiotherapy department, and with decreasing socioeconomic status.