Supportive care and healthcare service utilisation in older adults with a new cancer diagnosis: a population-based review.

Objectives: Older adults have unique needs and may benefit from additional supportive services through their cancer journey. It can be challenging for older adults to navigate the siloed systems within cancer centres and the community. We aimed to document the use of supportive care services in older adults with a new cancer diagnosis in a public healthcare system.

Methods: We used population-based databases in British Columbia to document referrals to supportive care services. Patients aged 70 years and above with a new diagnosis of solid tumour in the year 2015 were included. Supportive care services captured were social work, psychiatry, palliative care, nutrition and home care. Chart review was used to assess visits to the emergency room and extra calls to the cancer centre help line.

Results: 2014 patients were included with a median age of 77, 30% had advanced cancer. 459 (22.8%) of patients accessed one or more services through the cancer centre. The most common service used was patient and family counselling (13%). 309 (15.3%) of patients used community home care services. Patients aged 80 years and above were less likely to access supportive care resources (OR 0.57) compared with those 70-79 years. Patients with advanced cancer, those treated at smaller cancer centres, and patients with colorectal, gynaecological and lung cancer were more likely to have received a supportive care referral.

Conclusions: Older adults, particularly those above 80 years, have low rates of supportive care service utilisation. Barriers to access must be explored, in addition to novel ways of holistic care delivery.