Annals of Oncology Advance Access originally published online on August 5, 2005
Annals of Oncology 2005 16(12):1982-1983; doi:10.1093/annonc/mdi391
© 2005 European Society for Medical Oncology
Letter to the Editor |
Cancer and aging: are there any differences in the information needs of elderly and younger patients? Results from an Italian observational study
The importance of providing information to cancer patients, and the problems that can arise, have been well documented in recent decades [1
–4]. Unfortunately, as the review of Chouliara et al. [5] shows, only a few studies have focused on older cancer patients.
Between June and December 2004, we carried out an observational study to investigate the need for information and the psychological distress of elderly cancer patients admitted to the National Cancer Institute, Aviano, Italy. As a control group we chose younger patients admitted over the same period of time. We also investigated the caregiver knowledge of the patient's need for information. Inclusion criteria were as follows: first cancer; age 
65 years for the study group and 18–40 years for the controls; naivety to treatments; presence of a caregiver. One hundred and seventeen elderly cancer patients (mean age = 72.3 years, SD = 5.5, range 65–93) and 47 younger cancer patients (mean age = 32.8 years, SD = 6.7, range 18–40) were asked to fill in two self-administered questionnaires concerning the amount of information they requested about their illness; the sources of information they consulted, reasons and degree of satisfaction; and the level of psychological distress. All enrolled patients completed the questionnaires. Elderly patients mainly suffered from genitourinary (28.2%), breast/gynecological (26.5%) and gastrointestinal (21.4%) cancers, while younger ones were affected by breast/gynecological (53.2%), hematological (29.8%), and head and neck (10.6%) tumors.
The need for information about their diagnosis was: none at all (23.9%), notable (41%) or considerable (35.1%) for the elderly group and 2.1%, 25.1% or 72.4% for the control group, respectively (P <0.0001). The two groups also differed significantly in the need for information about disease seriousness, recovery, course of illness, and for all the other aspects considered. The results are shown in Table 1. While age was a statistically significant factor for the different need for information between the two groups, the level of psychological distress was similar (26.0 for elderly versus 26.6 for young). Sources of information were not referred to by one-third of the patients; only 77 elderly patients addressed the physician (41%), family doctor (37.6%), friends/relatives (22.2%), patients/survivors (22.2%), or booklets and scientific articles (8.6%) for additional information. The favorite sources of information for 45/47 of the younger patients were: the physician (66%), friends/relatives (57.5%), family doctor (53.2%), patients/survivors (44.7%), the Internet (23.4%) and booklets and scientific articles (19.2%). As expected, access to the Internet was not common to elderly patients (only three of 77), while 11/45 young patients used it. Overall, in the early phase of the illness, the physician was the most preferred source of additional information for 51.3% of elderly cancer patients and for 48.9% of younger ones.
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Our results demonstrate that, more frequently than expected, elderly Italian cancer patients do not want information on diagnosis, unlike younger Italians. Furthermore, elderly patients prefer personalized communication provided by a physician characterized by a patient-tailored level of information about their illness, treatment procedures, side-effects and their future conditions. In contrast, young patients want as much information as possible.
Division of Medical Oncology A, National Cancer Institute, Aviano, Italy
* E-mail: omaoffice{at}cro.it
References
1. Van der Molen B. Relating information needs to the cancer experience: 1. Information as a key coping strategy. Eur J Cancer Care 1999; 8: 238–244.
2. Maguire P. Improving communication with cancer patients. Eur J Cancer 1999; 35: 2058–2065.[CrossRef][Web of Science][Medline]
3. Jenkins V, Fallowfield L, Saul J. Information needs of patients with cancer: results from a large study in UK cancer centres. Br J Cancer 2001; 84: 48–51.[CrossRef][Web of Science][Medline]
4. De Lorenzo F, Ballatori E, Di Costanzo F et al. Improving information to Italian cancer patients: results or a randomized study. Ann Oncol 2004; 15: 721–725.
5. Chouliara Z, Kearney N, Stott D et al. Perceptions of older people with cancer of information, decision making and treatment: a systematic review of selected literature. Ann Oncol 2004; 15: 1596–1602.
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