Neal, Daisy, Morgan, Jenna L, Kenny, Ross, Ormerod, Thomas and Reed, Malcolm (2022) Is there evidence of age bias in breast cancer health professionals' treatment of older patients? European Journal of Surgical Oncology. pp. 1-7. ISSN 0748-7983

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Abstract

Objectives
Despite NICE (2009; 2018) guidelines to treat breast cancer patients ‘irrespective of age’, older women experience differential treatment and worse outcomes beyond that which can be explained by patient health or patient choice. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and perhaps perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as an explanatory factor in poorer outcomes for older breast cancer patients.

Methods
This mixed methods study explored age bias amongst breast cancer HCPs through four components: 1) An implicit associations test (31 HCPs)
2) A treatment recommendations questionnaire (46 HCPs)
3) An attitudes about older patients questionnaire (31 HCPs)
4) A treatment recommendations interview (20 HCPs).

Results
This study showed that breast cancer HCPs held negative implicit associations towards older women; HCPs were less likely to recommend surgery for older patients; some HCPs held assumptions that older patients are more afraid, less willing and able to be involved in decision-making, and are less willing and able to cope with being informed of a poor treatment prognosis; and conditions which disproportionately affect older patients, such as dementia, are not always well understood by breast cancer HCPs.

Conclusions
These results indicate that there are elements of age bias present amongst breast cancer HCPs. The study’s findings of age-based assumptions and a poorer understanding of conditions which disproportionately affect older patients align with patterns of differential treatment towards older breast cancer patients suggesting that age bias may be, at least in part, driving differential treatment.

Item Type:	Article
Keywords:	age bias, breast cancer, cancer, decision making, implicit bias, older patients, oncology, primary endocrine therapy, treatment recommendations
Schools and Departments:	Brighton and Sussex Medical School > Clinical and Experimental Medicine
SWORD Depositor:	Mx Elements Account
Depositing User:	Mx Elements Account
Date Deposited:	05 Jul 2022 14:04
Last Modified:	27 Apr 2023 10:33
URI:	http://sro.sussex.ac.uk/id/eprint/106816

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