Manjelievskaia et al1 present thought-provoking data that demonstrate an ethical issue. They reveal the disparity of cancer treatment based on age, not on data-driven guidelines. The “relative” simplicity of their study (and it is not simple) relies on clear definitions of age and insurance coverage.
The definition of age groups is prone to criticism. The authors use 50 years of age, the national recommendation for starting normal-risk screening colonoscopies. While recent statistics reveal colorectal cancer increased among patients aged younger than 50 years by 1.8% per year, compared with a decrease of 3% in patients aged between 50 and 75 years2 (which may alter screening guidelines), the cutoff of 50 years reflects current practices.
Young-Fadok TM. A Plea to Expand the Scope of Tumor Boards. JAMA Surg. Published online January 25, 2017. doi:10.1001/jamasurg.2016.5051