Korean J Geriatr Gerontol.  2024 Aug;25(2):87-98. 10.15656/kjgg.2024.25.2.87.

Navigating the Gray Zone: Physicians’ Perspectives on Treatment Decision-Making in Elderly Cancer Patients in Korea

Affiliations
  • 1Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
  • 2Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
  • 3Department of General Surgery, Yonsei University School of Medicine, Seoul, Korea
  • 4Department of Radiology, Samgsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background
To investigate awareness and perceptions related to treatment decision-making in elderly cancer patients among Korean cancer physicians.
Methods
Online survey was conducted from July to August 2022 among medical doctors working at general or tertiary general hospitals in Korea involved in treatment decision-making for elderly cancer patients. The questionnaire comprised single or multiple choice questions in four parts.
Results
382 Cancer physicians participated in this survey, 82.2% agreed that they would be less inclined to treat the patients if they were older, and among these participants, 91.8% reported the age threshold for less intensive treatment to be over 75 years. The top choice for the most important factor was “patient’s decision” (24.9%). “Functional status” (94.8%) ranked highest in importance agreement for the factors, followed by “patient decision”, “patient frailty”, and “cancer stage”. “I modify treatment plans for older cancer patients to take into account their level of frailty and overall functional status” had the highest agreement rate as a clinical practice in the treatment of elderly cancer patients (91.6%). Among the respondents, 85.1% agreed that it is necessary to develop clinical practice guidelines related to cancer treatment for the elderly, and also ‘development of clinical guidelines’ was the highest item as an area in need of improvement in treatment decision-making (38.7%).
Conclusion
In our study, we found that patient decision-making and functional status were important considerations in treatment decisions for older cancer patients. The development and dissemination of relevant clinical guidelines are needed to improve treatment decision-making for older cancer patients.

Keyword

Elderly; Neoplasms; Physician; Survey; Treatment decision-making
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