High prevalence of non-receipt of cancer-directed therapy among the oldest old persists independent of healthcare accessibility: A population-based analysis of 82,864 patients.

Authors

Se-Il Go, Rock Bum Kim, Mi-Ji Kim, Ki-Soo Park, Byeong Sun Moon, Woo Je Lee, Jung Hun Kang

Published in

Cancer epidemiology. Pages 103174. Jul 14, 2026. Epub Jul 14, 2026.

Abstract

Given Korea's rapid transition toward a super-aged society, investigating how demographic and clinical factors, particularly chronological age, are associated with treatment receipt and survival is essential for addressing the unmet needs of this expanding population.
Using a near-complete, provincial population-based cancer registry in Korea, we examined the proportion and factors associated with non-receipt of cancer-directed therapy among 82,864 patients diagnosed from 2018 to 2022. Treatment status was defined as receipt of any cancer-directed therapy within the registry-defined 120-day ascertainment period after the index date. Multivariable logistic regression identified factors associated with non-receipt of cancer-directed therapy, and overall survival was compared using Kaplan-Meier and Cox models.
Overall, 20.7% of patients had no recorded cancer-directed therapy within the ascertainment period. The likelihood of not receiving treatment increased sharply with age: among patients with distant disease, 52.1% of those aged 75-84 and 78.9% of those aged ≥ 85 remained untreated. Patterns also varied by cancer type, with pancreato-hepato-biliary cancers showing the highest non-treatment proportions across disease extent. After adjustment, residential region and the COVID-19 period had minimal associations with treatment receipt. Treated patients had markedly longer survival, yet outcomes among untreated patients were heterogeneous. After excluding hematologic malignancies, the 5-year survival rate of untreated patients with distant disease was 12.7%.
Older age was strongly associated with non-receipt of cancer-directed therapy, particularly in distant disease, but this association should be interpreted cautiously given unmeasured clinical and preference-related factors. Regional variation was minimal after accounting for age and disease extent.

PMID:
42448551
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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