This research project has been designed to evaluate factors that differentiate older from younger patient groups in terms of patient management procedures that have been shown to reduce the morbidity and mortality from breast cancer and rectal cancer in females. Given that younger white breast cancer patients do not experience differences in 1, 3 or 5 year relative survival compared with older age groups, and given that younger white female rectal cancer patients experience between 15 and 20% higher 1, 3, and 5 year relative survival compared with older patients, it is suggested that systematic differences may exist in prognostically significant patient management procedures, that are offered to and/or accepted by women with rectal cancer, which may not exist or exist to a lesser extent for breast cancer. Given the increased incidence of both cancers among the elderly, and the different role age seems to play with respect to survival between the two sites, it is extremely important to understand the impact that patient management and behavioral factors, in relation to disease and host characteristics, have on the patterns of care for a defined population of middle-aged and elderly female cancer patients. The Memorial Sloan-Kettering Cancer Center in collaboration with the New York State Department of Health, Cornell University Medical Center and the National Opinion Research Center, proposes to evaluate these issues by identifying a representative sample of New York City white female patients, 45 and older, with cancers of the breast or rectum, interviewing these patients and a support person named by each patient, obtaining clinical data from the patients' medical records and from the patients' physicians and analyzing these data to determine the effects of the variables of age, socio-economic status and site of disease on pre-treatment choices, treatment choices and follow-up care offered by the physician and chosen by the patient.
