Colorectal (bowel) cancer (CRC) is a disease of older people, with a median age at diagnosis of 70 years. However, CRC survival is decreased for patients > 65 years compared to their younger counterparts. Although older people tend to have other co-morbidities that affect survival, an earlier diagnosis and access to the most appropriate treatment makes a difference to cancer outcomes. However, evidence suggests that many older people are not being offered the optimal treatment. For older people living in regional settings, other factors (e.g. family support, travel) may further influence access to appropriate care.
We will explore whether a patient's age impacts on access to quality CRC treatment, as measured by multidisciplinary team (MDT) care, which is considered best practice in the treatment planning for patients with cancer. A one-year pilot study will focus on access to, and activation of, MDT care in regional settings, where the impact of age may be exaggerated. A mixed methods study will be applied. Clinical audit of an MDT database will be compared with population-level data analysis to explore patterns of CRC care for older people. Quantitative findings will be triangulated with thematic analysis of geriatric oncology decisions made at the Mt Gambier Multidisciplinary Cancer Assessment Team meeting.
This pilot study will identify key variables that influence MDT CRC care and finalise a survey design to establish the preferences of MDTs for alternative treatment regimens for older patients diagnosed with CRC for controlled testing in metropolitan and regional hospital MDTs across South Australia.