Hans Wildiers1, Murielle Mauer2, Monique Elseviers3, Jonas De Wolf4, Sigrid Hatse5, Marije Hamaker6, Frank Buntinx7, Jan De Lepeleire8, Geert Uytterschaut9, Claire Falandry10, Konstantinus Tryfonidis11, Maryska Janssen-Heijnen12. 1. Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium.. Electronic address: hans.wildiers@uzleuven.be. 2. Statistics Department, EORTC Headquarters, Avenue Emmanuel Mounier 83/11, 1200 Brussels, Belgium. 3. CRIC (Centre for Research and Innovation in Care), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium. 4. Antwerp University Hospital, Edegem, Belgium, University of Antwerp, Belgium, Ghent University Hospital, Belgium. 5. Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium. 6. Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands. 7. Department of General Practice, KULeuven, Kapucijnenvoer 35, Block J, B-3000 Leuven, Belgium. 8. Department of General Practice, KULeuven, Kapucijnenvoer 35, Block J, B-3000, Leuven, Belgium and UPC KU, Leuven, Belgium. 9. Elderly Care, Armonea nv, Stationsstraat 102, 2800 Mechelen, Belgium. 10. Geriatrics Unit, Hospices Civils de Lyon, CarMEN Laboratory, Lyon University, Pierre-Bénite, France. 11. EORTC Headquarters, Avenue Emmanuel Mounier 83/11, 1200 Brussels, Belgium. 12. Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, the Netherlands, Department of Epidemiology, Maastricht University Medical Centre+, GROW School for Oncology and Developmental Biology, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
Abstract
OBJECTIVES: This prospective multicenter cohort study aimed to describe new cancer events in nursing home residents (NHR). MATERIALS AND METHODS: The study was performed in 39 nursing homes from the Armonea network in Belgium, covering 4262 nursing home beds. All NHR in these homes were prospectively followed during 1 year for occurrence of cancer events (diagnosis or clinical suspicion of a new cancer or progression of a known cancer). After training, each site's local staff identified NHR with cancer events in collaboration with the treating general practitioner (GP). NHR with cancer events were included after informed consent, and data about general health and cancer status were collected every 3 months up to 2 years. RESULTS: In only nine NHR (median age 87 years, range 72-92), a cancer event was recorded during follow-up including five new (suspected or diagnosed) cancer events (incidence rate = 123/100.000 NHR per year) and four NHR with (suspected or diagnosed) progressive disease. In four NHR with suspected cancer, no diagnostic procedure was performed, and in five no anticancer treatment was started. CONCLUSION: Clinically relevant cancer events (potentially requiring diagnostic or therapeutic action) occur at a much lower frequency in NHR than expected from cancer incidence data in the general older population. Although some underreporting of cancer events cannot be excluded, this prospective study supports several previous retrospective observations that cancer events are rare in very frail older persons. Moreover, diagnostic and therapeutic actions for (suspected) cancer events are often not undertaken in this population.
OBJECTIVES: This prospective multicenter cohort study aimed to describe new cancer events in nursing home residents (NHR). MATERIALS AND METHODS: The study was performed in 39 nursing homes from the Armonea network in Belgium, covering 4262 nursing home beds. All NHR in these homes were prospectively followed during 1 year for occurrence of cancer events (diagnosis or clinical suspicion of a new cancer or progression of a known cancer). After training, each site's local staff identified NHR with cancer events in collaboration with the treating general practitioner (GP). NHR with cancer events were included after informed consent, and data about general health and cancer status were collected every 3 months up to 2 years. RESULTS: In only nine NHR (median age 87 years, range 72-92), a cancer event was recorded during follow-up including five new (suspected or diagnosed) cancer events (incidence rate = 123/100.000 NHR per year) and four NHR with (suspected or diagnosed) progressive disease. In four NHR with suspected cancer, no diagnostic procedure was performed, and in five no anticancer treatment was started. CONCLUSION: Clinically relevant cancer events (potentially requiring diagnostic or therapeutic action) occur at a much lower frequency in NHR than expected from cancer incidence data in the general older population. Although some underreporting of cancer events cannot be excluded, this prospective study supports several previous retrospective observations that cancer events are rare in very frail older persons. Moreover, diagnostic and therapeutic actions for (suspected) cancer events are often not undertaken in this population.