Access to Care and Prognosis in Elderly With Cancer (INCAPAC Study)

Cancer Clinical Trial

Official title:

Access to Care and Prognosis in Elderly Cancer Patients: Analysis of Determinants Using Data From Cancer Registries and Cohort Studies in Gironde, French Department

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03694171
• Other study ID #: IB2013 INCAPAC
• Status: Completed
• Start date: November 2013
• Est. completion date: November 2017

Study information

• Verified date: May 2019
• Source: Institut Bergonié
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The growing incidence of cancer associated to an aging population represents an epidemiologic reality that requires questioning access to care and prognosis in elderly with cancer, for which disparities have been highlighted. However, generally speaking, studies are limited in that they overlook geriatric-specific factors. The aim of this work was to study sociodemographic, socioeconomic and clinical determinants of access to care (cancer stage, cancer treatment) and prognosis (functional decline, survival) in elderly cancer patients.

Description:

The French department of Gironde (1.5 million inhabitants) is covered by cancer registries. In addition, three cohorts were initiated in Gironde on cerebral and functional aging that enrolled subjects aged 65 years and over: the PAQUID study (1988), the 3-City study (1999), and the AMI study (2007). In these cohorts, a large amount of individual data on the participants has been collected longitudinally at different follow-up visits, conducted every two or three years.

Using cancer registries, older subjects with cancer were identified in the cohort studies. Subjects were included if they presented the following: i) aged 65 years and over from one of the three cohorts, ii) alive on January 1st 2005 (common start date for tumor recording) and resident in Gironde, and iii) with a validated cancer diagnosis recorded in one of the cancer registries from January 1st 2005 to December 31st 2014. All tumors for which data is annually sent by cancer registries to the International Agency for Research of Cancer were included: invasive malignant tumors and benign tumors of the central nervous system. As the incidence of skin tumors in older cancer patients is high, they were also included. For patients with multiple tumors, only one was considered: either the first one diagnosed if there were several tumors with a minimum of a 6 months interval between their diagnosis, or the one with the worse prognosis if there were several tumors diagnosed within 6 months.

In order to not consider information concerning patients' characteristics that was too old, subjects with a delay between the last completed cohort follow-up visit before the cancer diagnosis and the diagnosis of cancer equal or superior to 6 years were excluded.

Variables were extracted from cohorts and registries at different times: cohort inclusion, pre-diagnosis visit, cancer diagnosis or registries follow-up.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 450
• Est. completion date: November 2017
• Est. primary completion date: November 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years to 110 Years

Eligibility

Inclusion Criteria:

• Age = 65 years

• Alive on January 1st 2005 ( PAQUID or 3-City cohorts) or included in the AMI cohort study

• Cancer diagnosis recorded in one of the cancer registries in Gironde, French department

Related Conditions & MeSH terms

• Cancer

Locations

Country	Name	City	State
France	Institut Bergonié	Bordeaux

Sponsors (3)

Lead Sponsor	Collaborator
Institut Bergonié	Institut National de la Santé Et de la Recherche Médicale, France, University of Bordeaux

Country where clinical trial is conducted

France, 

References & Publications (2)

Galvin A, Delva F, Helmer C, Rainfray M, Bellera C, Rondeau V, Soubeyran P, Coureau G, Mathoulin-Pelissier S. Sociodemographic, socioeconomic, and clinical determinants of survival in patients with cancer: A systematic review of the literature focused on — View Citation

Galvin A, Helmer C, Coureau G, Amadeo B, Joly P, Sabathe C, Monnereau A, Baldi I, Rainfray M, Soubeyran P, Delva F, Mathoulin-Pelissier S. Determinants of cancer treatment and mortality in older cancer patients using a multi-state model: Results from a po — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cancer stage at diagnosis	Advanced stage at diagnosis measured from cancer registries data	2005 to 2014
Primary	Cancer treatment	Receipt of cancer treatment (all treatment considered) from cancer registries data	Through study completion
Primary	Functional decline	Change in functional status between cancer pre-diagnosis assessment and cancer post-diagnosis assessment measured with Instrumental Activities of Daily Living (IADL) scale	An average of 2 years
Primary	Functional decline	Change in functional status between cancer pre-diagnosis assessment and cancer post-diagnosis assessment measured with Activities of Daily Living (ADL) scale	An average of 2 years
Primary	Survival	Time from cancer diagnosis to death or last follow-up, whichever came first	July, 31st 2017