In a poster discussion today (Tuesday) at the European Cancer Conference (ECCO 14) in Barcelona, Dr Tania Estapé said: "This reports shows how important it is to improve and increase the cancer education programmes that are targeted towards older people."
Dr Estapé, a psychosocial programme coordinator in the psychosocial oncology department at the Fundación para la Educación y la Formación en Cáncer (FEFOC), Barcelona, Spain, said that misconceptions about cancer could be very damaging. "Some attitudes and misconceptions about cancer may lead to the elderly avoiding or not participating fully in a healthy lifestyle. For instance, more than half of our respondents did not know that being overweight is a risk factor for cancer," she said.
She and her colleagues questioned 557 people aged 65 and over in one-to-one interviews. The average age was 74. When asked about prevention and early diagnosis, only 53.5% believed that cancer could be prevented and 94% did not know the European Code against Cancer, although they knew some of its recommendations; for instance, over 90% knew to avoid smoking, excessive alcohol and sunbathing. However, only 45.8% knew about the impact of diet on cancer and only 38.1% knew about avoiding being overweight. Three-quarters knew that cancer could be diagnosed early, but only 44% knew about the PSA test for prostate cancer and 34% knew about early detection of breast cancer. Men appeared to be better informed than women about early diagnosis, with more men believing in the possibility of early diagnosis for prostate, breast and colon cancer.
When asked what they knew about cancer, 66% believed that cancer did NOT increase with age, nearly 60% said it could be cured, 2% believed that cancer was a contagious disease, while 8.7% said they did not know, 3% believed that cancer was punishment for something you had done wrong, while 6% were not sure about this statement.
Knowledge about cancer treatment and research was mixed, with 56% believing that the treatment was worse than the cancer itself, 44.7 % and 23.1% believing that mastectomy and prostatectomy respectively were the only ways to cure breast and prostate cancer, and 55.2% and 48.3% believing that chemotherapy and radiotherapy respectively were dangerous. Less than a third (31%) knew the meaning of a "clinical trial", 23% knew what "placebo" meant, and only 4.2% understood the term "randomisation".
Responses did not vary much among the 89 (17.2 %) people who had had cancer in the past, apart from the fact that more believed it could be cured (71.85% compared to 57.25% among people who had not had cancer), and fewer believed in the importance of psychological support (62.5% among cancer survivors versus 69.75% among those who had never had cancer). This last finding appears counter-intuitive, but Dr Estapé believes this might be due to the fact that with few psycho-oncologists available in Spanish hospitals, the elderly cancer survivors might not have had access to them and, in addition, might have assumed that being depressed when having cancer was normal. "On the other hand, healthy people, who have not experienced cancer may assume that it would be horrible and that they would be very anxious, depressed, distressed and in need of psychological support, but when people actually do have cancer they experience lower levels of these emotions."
Dr Estapé concluded: "At the moment, our elderly people come from a time when health information was poor, cancer was often thought of as an incurable disease, and therefore there was nothing that could be done to prevent or to cure it. I think our younger generations will be better informed.
"However, we need to try to improve the knowledge of our elderly so that they can understand that a diagnosis of cancer is not automatically a death sentence, and that there are lifestyle changes they can make now to reduce their risk of cancer developing. This is being done through public education sessions led by our Foundation, which includes topics on the European Code against Cancer and psychosocial barriers in the elderly. Information must be presented in a clear and easy manner, and the participation of care-givers and other assistants should be encouraged."