Stage III colon cancers - Why adjuvant chemotherapy is not offered to elderly patients

Hypothesis: Adjuvant chemotherapy is not offered to elderly patients with s tage III colon canter. Design: A retrospective review of hospital and office records. Setting: A suburban community hospital. Patients: The medical records of 69 patients with stage III colon cancer were reviewed. All identified from th e Tumor Registry at Jersey Shore Medical Center, Neptune, NJ, were included in this study. Results: Thirty-five patients (51%) did not receive adjuvant chemotherapy. After adjusting forage, women were 5.8 times less likely to receive chemoth erapy (P = .002). Patients not receiving chemotherapy were significantly ol der (78.7 vs 70.4 years; P = .003) than those who received adjuvant chemoth erapy. There was no relation found between the year of diagnosis and the ad ministration of chemotherapy. There were LF major reasons for not receiving chemotherapy: (1) not offered (n = 12, 34%), (2) refused (n = 11, 31%), (3 ) too old (n = 7, 20%), and (4) significant concomitant disease (n = 5, 14% ). Conclusions: A large group of elderly patients who had been surgically trea ted for colon cancer and who were eligible for adjuvant chemotherapy either were not referred for treatment or refused treatment. This suggests a bias on the part of surgeons, primary care physicians, and patients against the use of chemotherapy in elderly patients.