Care Pathways and Disparities in Care for Older Patients With Cancer: Typology, Determinants and Effect on Prognosis ( PASSAGE ) (PASSAGE)

More than half of new cases of cancer in Europe in 2022 occurred in people aged over 70. In addition to cancer, the majority of older people have one or more illnesses that may interact with the treatment decision, cancer progression, tolerance and efficacy of treatments, quality of life, care pathway and survival. Furthermore, cancer treatments are most often evaluated in middle-aged subjects without severe disease, so the real-life management of older patients is often empirical.

The general objective of the PASSAGE project is to assess the hospital care pathways of older patients with cancer treated at AP-HP by evaluating key elements of these pathways from both geriatric and therapeutic perspectives. Characterizing these care trajectories will help identify the most vulnerable patient profiles and potential disparities in access to care, with the goal of optimizing the management of elderly patients with cancer.

The aims of this research are 1) to provide a better description of trends in the management of older cancer patients in routine clinical practice, and 2) to assess the impact of frailty, multimorbidity and the management of these patients on the prognosis of the disease.

Study Overview

• Status: Active, not recruiting
• Conditions: Cancer; Tumor; Aged; Geriatric Assessment; Health Services Research; Causality

• Study Type: Observational
• Enrollment (Estimated): 75000

Contacts and Locations

Study Locations

• France
  • VAL DE Marne
    • Créteil, VAL DE Marne, France, 94010
      • Henri Mondor Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

elderly cancer patients treated at AP-HP

Description

Inclusion Criteria:

• Patients aged 70 or over,
• Having at least one International Classification of Disease, 10th revision (ICD-10) for solid cancer recorded as principal diagnostic or related,
• During treatment in an AP-HP hospital,
• Between 01/08/2017 and 31/07/2023.

Exclusion Criteria:

• opposition to the reuse of healthcare data

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Patients aged 70 or over with solid cancer; The following inclusion criteria will be applied to identify the study population: Patients aged 70 or over,; Having at least one International Classification of Disease, 10th revision (ICD-10) code for solid cancer recorded as principal diagnostic or related,; During treatment in an AP-HP hospital,; Between 01/08/2017 and 31/07/2023.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
type of care pathway	The primary endpoint is the type of care pathway as identified by longitudinal clustering analysis of Electronic Health Record (EHR) data in the year following diagnosis (medical diagnoses, procedures, admissions, treatment received),.	from cancer diagnosis during a year of follow-up

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborators: Inria, the French National Institute for computer science and applied mathematics; CentraleSupelec School of Engineering

Study record dates

Study Major Dates

• Study Start (Actual): September 7, 2024
• Primary Completion (Estimated): August 31, 2028
• Study Completion (Estimated): August 31, 2028

Study Registration Dates

• First Submitted: July 22, 2025
• First Submitted That Met QC Criteria: July 29, 2025
• First Posted (Actual): July 30, 2025

Study Record Updates

• Last Update Posted (Actual): July 30, 2025
• Last Update Submitted That Met QC Criteria: July 29, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: cancer; Frailty; ageing; care pathways
• Other Study ID Numbers: APHP240996; CSE-24-08_PASSAGE (Other Identifier: Institutional Review Board (IRB) of the AP-HP's Clinical Data Warehouse (CDW))

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data are available upon reasonable request. Proposals should be directed to ASSISTANCE PUBLIQUE HOPITAUX DE PARIS (AP-HP), Department for Clinical Research, Innovation (DRCI) represented by Mr Milan LAZAREVIC , Director. To gain access, data requestors will need to sign a data transfert agreement with the sponsor

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No