Cancer in nursing homes: what do we know?

Introduction: Cancer is a disease of ageing, with one in two men and one in three women in Australia developing cancer by the age of 85. Data from the US suggests that between 9-11% of RACF residents were living with cancer in 2008. However, there is little information available about the prevalence of cancer in Australian RACFs despite the potential importance of RACFs in the care of the elderly cancer patients. The purpose of the current pilot project was to conduct an exploratory study to describe the incidence and prevalence of cancer in the RACF population in Western Australia. Methods: Data from the WA Cancer Registry between 1998 and 2008 was used to identify residence of diagnoses at a RACF based on address text, key words or letter combinations; on exact matching to a list of categorized Health Establishment names; or on their address being geo-coded to exactly the same point as a relevant Establishment despite non-matching names. Outcomes: 88,545 people in WA were diagnosed with cancer between 1998 and 2008, Of these, 2,178 (2.5%) had a nursing home (NH) address. Patients with RACF address were older when diagnosed than non-RACF patients (80.9 vs 62.4 years, p<0.001). Conclusion/Recommendations: A variety of factors contribute to the low prevalence of cancer diagnosis in RACF's, including limitations in the registry data (e.g., residents diagnosed with cancer in another setting who move into an RACF); age at diagnosis (e.g., most cancer patients are younger and have family/social support systems at diagnosis avoiding RACF placement); and lack of data on RACF residents who may have had or have cancer as a secondary or co­ morbid diagnosis. Future work could include a retrospective RACF medical record review to identify residents with cancer and a preliminary description of the usual course of care for RACF cancer patients.