Association between age and the utilization of radiotherapy in Ontario

Purpose: The purpose of this study was to assess whether: (i) radiotherapy (RT) utilization varies with age in Ontario cancer patients; (ii) age-assoc iated differences in the use of RT (if they exist) vary with cancer site an d treatment intent; (iii) the age-associated variation in RT utilization is comparable to the decline in functional status in the general population; and (iv) the variation with age is due to differences in referral to a canc er center or to subsequent decisions. Methods and Materials: Details for several cancer sites diagnosed between 1 984-1994 were obtained from the Ontario Cancer Registry (OCR), RT records f rom all treatment centers were linked to the OCR database. Information abou t the functional status of the Canadian population was obtained from the 19 94 National Population Health Survey conducted by Statistics Canada. Results: The rate of RT use declined with age, particularly for adjuvant an d palliative indications. The relative decline in RT with age exceeded the relative decline in functional status with age in the general population. M ost of the decline in RT use was related to a decline in referral to cancer centers. Conclusions: The referral for, and use of, palliative and adjuvant RT decre ases more with age than can be explained by age-associated decline in funct ional status observed in the general population. (C) 2000 Elsevier Science Inc.