211723 Information-seeking and the age disparity in adjuvant treatment among colorectal cancer patients

Monday, November 9, 2009

Andy Tan, MBBS, MPH, MBA , Annenberg School for Communication at University of Pennsylvania, Philadelphia, PA
Derek Freres , Annenberg School for Communication, Philadelphia, PA
Katrina Armstrong, MD, MSCE , Director, Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
J. Sanford Schwartz, MD , Department of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, PA
Robert Hornik, PhD , Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
Introduction: Older patients with stage II or III colorectal cancer (CRC) are less likely to receive recommended adjuvant treatment after surgery compared to younger patients. This may be due to age-differences in information-seeking about CRC treatment. Objective: This study (1) compares information-seeking behaviors of older and younger CRC patients and (2) assesses the association of information-seeking with patients' receipt of adjuvant treatment in different age groups. Methods: We conducted a cross-sectional population-based survey among a representative sample of stages II or III CRC patients from the 2005 Pennsylvania Cancer Registry (N=300) in 2006 and measured participants' demographic characteristics, self-reported cancer treatments received, and treatment-related information-seeking from medical and non-medical sources. Results: In a multivariate logistic regression model adjusted for demographics, cancer stage, and medical source information-seeking, age and seeking from non-medical sources interacted significantly (p<0.01). Non-medical information-seeking was associated with increased receipt of adjuvant treatment in patients 65 and older only. Among older patients, the predicted probability of receipt of adjuvant treatment increased from 44.0% to 71.7% if they sought treatment information from at least one non-medical source. For younger patients predicted adjuvant treatment was above 87% regardless of seeking. Seeking from medical sources was not associated with adjuvant treatment in this model. Conclusion: This study shows that information-seeking from non-medical sources may reduce the age-disparity in the treatment of CRC patients. The findings may contribute towards designing effective communication interventions to increase utilization of recommended adjuvant treatment among older CRC patients and reduce the overall CRC disease burden.

Learning Objectives:
1. Describe the differences in information-seeking between older and younger colorectal cancer patients. 2. Describe the association of information-seeking with the receipt of adjuvant treatment for colorectal cancer in different age groups.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have several years experience
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.