[Are old and young cancer patients being treated differently?]

Research suggests that cancer patients' age may affect the quality of their treatment. Yet, there is little knowledge of how and why age affects treatment quality. This study explores staff attitudes and perceptions of age-related differences in treatment and care at a Danish oncology department.

Qualitative analyses of nine semi-structured interviews with strategically selected staff members were conducted using a grounded theory-inspired approach. The interviews were independently coded by four raters through a process of meaning condensation and meaning was structured into core-categories.

Although eight of nine participants denied that age was a reason for differential treatment, all nine participants gave examples of age-related differences in treatment. Younger patients were generally offered: 1) more intensive treatment, 2) more consultation time with physicians, 3) allocation to physicians with higher seniority, and 4) increased continuity in the staff assigned to them. The differences were explained as due to: a) differences in patients' physical health and b) sympathy for younger patients' life situation and needs.

Two co-dominant values were identified: 1) "equality in treatment and care" and 2) "normative life course expectations" of serious disease belonging to old age and thus being more tragic for young individuals (life script model). Values of equality are explicit and govern formal health care system guidelines, while values related to the staff's life course expectations are more implicit and may account for some age-related differences in treatment quality.