Accès gratuit
Numéro
Med Sci (Paris)
Volume 23, Octobre 2007
Le cancer du sujet âgé : le dilemme du vieillissement
Page(s) 52 - 56
Section Annexe
DOI https://doi.org/10.1051/medsci/2007233s52
Publié en ligne 15 octobre 2007

© 2007 médecine/sciences - Inserm / SRMS

Objectifs

Ce projet a pour objectif principal de décrire les conséquences d’un cancer du sein sur le devenir à long terme de femmes de 65 à 80 ans : conséquences sur leur vie sociale, leur vie quotidienne, leur qualité de vie et leur survie (voir p. 53 et 54 la liste de références bibliographiques [1107] pour l’étude Ellipse Femmes 65-80 ans). Plusieurs thèmes sont particulièrement étudiés : la place des co-morbidités par rapport à la maladie du sein, l’importance de l’image du corps chez la femme âgée, l’observance aux traitements adjuvants et aux chimiothérapies orales, l’adéquation entre les besoins perçus et les aides existantes.

Les données sur les circonstances du diagnostic, les caractéristiques de la tumeur et les traitements, qui sont collectées de façon rétrospective au moment de l’initiation de l’enquête, permettront, en comparant des groupes de femmes d’âge différent, de répondre aux deux objectifs secondaires de l’enquête : préciser l’effet de l’âge d’une part sur la prise en charge médicale du cancer du sein, et d’autre part sur l’information délivrée et la participation aux choix thérapeutiques.

Problématique

Le devenir des survivants et les conséquences à long terme de la maladie cancéreuse sont encore très mal connus, en particulier chez les personnes âgées, population très hétérogène, pour laquelle il n’existe pas de recommandations standardisées concernant la prise en charge du cancer et qui n’a pas fait l’objet d’études longitudinales sur le long terme. Parce que le cancer du sein est une maladie fréquente dont l’incidence atteint son maximum vers 70 ans, il est généralement considéré comme un excellent modèle pour étudier les enjeux spécifiques de la prise en charge carcinologique à un âge élevé. Par ailleurs, la région PACA est l’une des régions françaises où l’index de vieillissement est le plus élevé, ce qui permet d’y envisager la mise en place d’une cohorte de femmes âgées représentative d’un problème de santé national comme le cancer du sein.

Méthodes

Une enquête longitudinale avec un recueil prospectif de l’information, répété dans le temps, est réalisée dans trois départements de la région PACA (Alpes-Maritimes, Bouches-du-Rhône, Var) auprès de l’ensemble des femmes de 65 à 80 ans ayant fait l’objet d’une déclaration d’affection de longue durée (ALD) pour cancer du sein à partir de novembre 2006. Les femmes qui acceptent d’être incluses dans la cohorte auront un suivi comprenant la visite d’un enquêteur à leur domicile à 10 mois du diagnostic, puis un entretien téléphonique à 2 et 5 ans. En parallèle, une fiche médicale annuelle est collectée auprès des médecins traitants désignés par les patientes.

Échéancier

Début de l’enquête novembre 2006. Premiers face à face août 2007. Inclusion pendant 18 mois (800 femmes à inclure). Durée de l’enquête : 5 ans.

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