Assessing time to treatment initiation and care delivery among patients with cancer and co-occurring Alzheimer's disease and related dementia using claims data.

Abstract

161 Background: Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in Americans. Prognosis for survival is better if cancer is detected at an early stage, the patient is from a majority racial/ethnic group, and not a member of an older age cohort ( > 65). Risk is also exacerbated when a patient is dealing with concurring condition such as Alzheimer's Disease or dementia (ADRD)which affects approximately 10% of older adults. Methods: A SEER-Medicare cohort of patient with CRC from 2004-2013 was obtained from the NCI. After appropriate criteria were applied, only cases with all data for cancer and ADRD and first cancer-related treatment were included for an analysis sample of N = 54, 357. Results: The prevalence of concurrent ADRD and CRC in our sample was 3.1%. Mean time to treatment initiation (TTI) was 34.99 days for all patients, and 35.19 days for patients in the CRC-only group vs ~ 27 days in the CRC+ADRD group. Most patients in either group were Stage II though TTI decreased as patient stage at diagnosis increased. Conclusions: Using claims data to assess TTI in cancer patients suggests that TTI is shorter for patients with concurrent ADRD. While this may be attributable to ADRD patients existing interactions with the care delivery systems and the role of caregivers it is evident that additional contextual research is necessary to consider these systems and non-clinical factors.