More on older men and women, cancer and the Cancer Reform Strategy. This time - cancer awareness
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The baseline report on the Cancer Awareness Measure was published by the Department of Health in November last year and gives the results from two national surveys using the CR-UK Cancer Awareness Measure (CAM). The CAM was developed as part of the National Awareness and Early Diagnosis Initiative (NAEDI) to implement the Cancer Reform Strategy. The CAM surveys benchmarked current levels of national cancer awareness, to provide a baseline against which to identify progress on ‘awareness’. Like the Survivorship Initiative Vision from January this year it also misses the point on ageing and cancer, by miles.
The study does not reveal much about one particular ‘hard to reach’ group; men and women over 75. Ageing men and women are the population most likely to get cancer and most likely to be juggling multiple co-morbidities, possibly also their partner’s, a fluctuating health status, the impairments of an ageing body and all the other slings and arrows that older age hurls.
As ageing is the single largest risk factor for receiving a cancer diagnosis, knowing how the ‘aged’ might respond to cancer symptoms is a major gap in the evidence base. In the CAM study only 28% of people in the sample were over 65. How many were over 70, or 80? Just how robust was the data quality in older men and women? It could be informative to see the results that relate to men and women aged 75 and over, alone. Over one third of new cancer diagnoses are in men and women in that age group.
About 64% of new cancer diagnoses are in people over 65. Over a fifth are in men and women aged 80 and over. The ONS sample used in the CAM study, whilst claimed as representative of the UK population, is clearly not representative of the population who are mostly likely to be diagnosed with cancer, the ones who are most important in cancer awareness raising. Older men and women have the most complicated health background against which to pick out bodily changes and make choices about reporting symptoms so their behaviour, understanding and possible responses need to be thoroughly investigated.
A new cohort specific study of the CAM in men and women over 75 is needed. Late presentation is constantly bandied about as a pat explanation for some poorer outcomes in this group so we need to understand what proportion of this is caused by lack of knowledge or understanding and how cancer in older people is perceived by older people. The gain is tackling inequality head on, to improve quality of life, wellbeing and outcomes.
