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Wildiers H, Mauer M, Elseviers M, De Wolf J, Hatse S, Hamaker M, Buntinx F, De Lepeleire J, Uytterschaut G, Falandry C, Tryfonidis K, Janssen-Heijnen M. Cancer events in Belgian nursing home residents: An EORTC prospective cohort study. J Geriatr Oncol 2019; 10:805-810. [PMID: 30898534 DOI: 10.1016/j.jgo.2019.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/02/2019] [Accepted: 03/09/2019] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium..
| | - Murielle Mauer
- Statistics Department, EORTC Headquarters, Avenue Emmanuel Mounier 83/11, 1200 Brussels, Belgium
| | - Monique Elseviers
- CRIC (Centre for Research and Innovation in Care), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Jonas De Wolf
- Antwerp University Hospital, Edegem, Belgium, University of Antwerp, Belgium, Ghent University Hospital, Belgium
| | - Sigrid Hatse
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Marije Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - Frank Buntinx
- Department of General Practice, KULeuven, Kapucijnenvoer 35, Block J, B-3000 Leuven, Belgium
| | - Jan De Lepeleire
- Department of General Practice, KULeuven, Kapucijnenvoer 35, Block J, B-3000, Leuven, Belgium and UPC KU, Leuven, Belgium
| | | | - Claire Falandry
- Geriatrics Unit, Hospices Civils de Lyon, CarMEN Laboratory, Lyon University, Pierre-Bénite, France
| | | | - Maryska Janssen-Heijnen
- 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
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