In breast cancer, are treatments and survival the same whatever a patient's age? A population-based study over the period 1998-2009.

AIM: The present study aimed to describe treatments, relative survival and prognostic factors in breast cancer patients according to age. METHODS: All women with primary invasive breast cancer, diagnosed from 1998 to 2009 in the department of Côte d'Or, were retrospectively selected. Variations in treatments administered according to age (<50 years, 50-74 years, >74 years) and period were assessed using Cochran-Armitage trend tests and χ(2) -tests, respectively. Prognostic factors according to age were estimated using a generalized linear model with a Poisson error structure. RESULTS: Overall, 4305 women were included. The oldest women (aged >74 years) were more likely than the youngest women to have comorbidities, advanced stage tumors, hormone receptor-positive tumors and be human epidermal growth factor receptor 2-negative. The use of breast conserving surgery plus adjuvant therapy decreased in older women (>74 years), whereas the proportions of women without treatments and with adjuvant hormone therapy increased with age. Multivariate relative survival analyses according to age showed an increased risk of death in women aged 50-74 years and >74 years with comorbidities compared with those without comorbidities; relative excess risks were 1.85 (1.13-3.02) and 3.23 (1.26-8.31), respectively. In contrast, a decreased risk of death was observed in women aged 50-74 years diagnosed by medical imaging compared with those diagnosed by clinical signs; relative excess risks 0.44 (0.22-0.89). CONCLUSION: Elderly women compared with the youngest women were diagnosed with more favorable tumor biology (hormone receptor-positive tumors, human epidermal growth factor receptor 2-negative). However, survival was poor in elderly women who had comorbid conditions, did not attend screening mammography examinations and were undertreated.

Population-based study of ovarian cancer in Côte d'Or: prognostic factors and trends in relative survival rates over the last 20 years.

BACKGROUND: The aim of this population-based study was to assess independent prognostic factors in ovarian cancer using relative survival (RS) and to investigate changes in RS rates from 1982 to 2005. METHODS: Data on 748 patients with ovarian cancer were provided by the Côte d'Or gynaecologic cancer registry. The RS was estimated using a generalized linear model with a Poisson error structure. Relative survival and its 95% confidence interval (CI) were described at the following specific time points 1, 3 and 5 years. The effect of prognostic factors on survival was assessed with multivariate analyses of RS. RESULTS: The median follow-up was 12 years. The RS rates at 1, 3 and 5 years were 81%, 55% and 44%, respectively. As compared with the period 1982-1989, an improvement in survival was found for the period 1998-2005: HR = 0.52[0.40-0.67]. Women who lived in urban areas had better RS: HR = 0.82[0.67-0.99]. Patients with epithelial types of ovarian cancer other than mucinous or endometrioid cancer had worse RS than those with serous histology. Age ≥ 70 years was associated with lower survival. CONCLUSIONS: Period of diagnosis, stage at diagnosis, histology, place of residence and age were independent prognostic factors for survival in ovarian cancer. An improvement in the survival rate was observed after 1998 but a significant improvement was limited to advanced stage cancers.