Proxy decision making for older women with breast cancer
Research type
Research Study
Full title
Proxy decision making for older women with cognitive impairments and breast cancer
IRAS ID
167829
Contact name
Charlene Martin
Contact email
Sponsor organisation
School of Medicine and Biomedical Sciences
Duration of Study in the UK
2 years, 2 months, 31 days
Research summary
The UK’s ageing population is growing rapidly; 1 in 6 people are now aged over 65 (ONS 2013) and over a third of all breast cancers in England are diagnosed in women over the age of 70 (Public Health England, 2014). Within this demographic, the prevalence of dementia is around 10.5% (Knapp et al. 2007), meaning that approximately 1260 women with cognitive impairment each year are likely to present with breast cancer.
This is an important area of research as studies have found that older women with breast cancer are generally treated less aggressively than younger women (Malik et al. 2013, Lavelle et al. 2014) and are less likely to receive gold standard care for their cancer (surgical intervention, chemotherapy, radiotherapy) (Harder et al. 2013). Older women with late stage dementia are also more likely to lack mental capacity to make decisions regarding their breast cancer treatment, and subsequently treatment decisions may rely on a proxy (i.e. their formal or informal carer making a decision on the patient’s behalf). Little is known about how decisions are made for this sub-population of older women with co-existent dementia, and there are few decision-making recommendations tailored specifically towards older women with dementia and a breast cancer diagnosis.
This study will use a pragmatic mixed method approach to explore the experiences of caregivers who are involved in making a proxy treatment decision for an older adult with dementia and breast cancer. The purpose of this study will be to understand how proxy decisions are made and the psychosocial factors that impact on carers during this process. The results from this study will contribute to the wider literature addressing the needs of caregivers and guide best practice towards proxy decision-making in breast cancer care.
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
15/YH/0292
Date of REC Opinion
25 Feb 2016
REC opinion
Further Information Favourable Opinion