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Ageism and surgical treatment of breast cancer in Italian hospitals

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Abstract

Aim

To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice.

Methods

Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis.

Results

The proportion of conservative breast cancer operations was 70.9%. A greater number of women younger than 70 had undergone a breast-conserving operation compared to older women. There were regional variations ranging from a minimum in Basilicata to a maximum in Val d’Aosta. Multivariate analysis revealed that older patients with lower clinical severity were more likely to have undergone a radical operation than younger women. In addition, radical surgery was approximately twice as likely to occur in a private hospital that performed at least 50 breast cancer operations annually than in a public hospital that performed <50 breast surgeries.

Conclusion

Notwithstanding increases in life expectancy and the lack of clinical evidence to support the use of age as a surrogate for co-morbid conditions and frailty, our data on breast cancer operations in Italy are consistent with the hypothesis suggesting the persistence of ageistic practice in the healthcare system.

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Acknowledgements

We want to thank the “Agenzia Nazionale per i Servizi Sanitari Regionali” for providing the national database on Hospital Discharge Forms.

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Authors and Affiliations

  1. Scientific Direction, National Institute of Health and Science on Aging-I.N.R.C.A., Ancona, Italy

    Mirko Di Rosa, Carlos Chiatti, Joseph M. Rimland & Fabrizia Lattanzio

  2. Local Health Unit, Latina, Italy

    Marina Capasso

  3. Section of Hygiene and Public Health, Polytechnic University of the Marche Region, Ancona, Italy

    Valerio M. Scandali & Emilia Prospero

  4. Unit of Geriatric Pharmacoepidemiology, National Institute of Health and Science on Aging-I.N.R.C.A., Cosenza, Italy

    Andrea Corsonello

Authors
  1. Mirko Di Rosa
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  2. Carlos Chiatti
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  3. Joseph M. Rimland
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  4. Marina Capasso
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  5. Valerio M. Scandali
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  6. Emilia Prospero
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  7. Andrea Corsonello
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  8. Fabrizia Lattanzio
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Corresponding author

Correspondence to Carlos Chiatti.

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No conflict of interest has been declared by the authors.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Di Rosa, M., Chiatti, C., Rimland, J.M. et al. Ageism and surgical treatment of breast cancer in Italian hospitals. Aging Clin Exp Res 30, 139–144 (2018). https://doi.org/10.1007/s40520-017-0757-0

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  • DOI: https://doi.org/10.1007/s40520-017-0757-0

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