PERFORMANCE STATUS AND COMORBIDITY IN ELDERLY CANCER-PATIENTS COMPARED WITH YOUNG-PATIENTS WITH NEOPLASIA AND ELDERLY PATIENTS WITHOUT NEOPLASTIC CONDITIONS

BACKGROUND. Elderly people constitute a heterogeneous group and are at an increased risk for the development of cancer. It is not clear whet her comorbid conditions and functional status influence clinical decis ions and the pattern of referral in elderly cancer patients. The curre nt study investigated functional status measured by Eastern Cooperativ e Oncology Group performance status, comorbid conditions, and medicati on taken as well as social environment in three series of patients gro uped according to age and diagnosis. METHODS. A total of 593 patients were involved: 138 neoplastic patients age > 70 years with breast, col on, or prostate carcinoma, 177 neoplastic patients age < 70 years with the same types of pathology, and 278 elderly patients with nonneoplas tic conditions. Patients with neoplastic disease were recruited from c ancer centers; patients with nonneoplastic disease were recruited from either geriatric or general medicine departments. Differences in the distribution of variables were analyzed by univariate and bivariate an alyses. RESULTS. No significant differences in social environment, mar ital status, or education were observed. Statistical differences were noted when comparing the distribution of comorbidities, performance st atus, and medication taken, elderly neoplastic patients presented in p oorer condition compared with younger patients but in better condition compared with elderly patients with nonneoplastic disease. CONCLUSION S. The overall better health of older cancer patients compared with th ose without cancer needs to be assessed further. It is possible that c ancer is more likely to be diagnosed in healthier elderly, or that pri mary care providers are reluctant to refer for cancer care patients in poor general health. Studies of comorbidity, function, and social res ources are necessary to establish the impact of cancer on survival and quality of life of older patients and to determine the social resourc es necessary for adequate care. (C) 1998 American Cancer Society.