Age Bias in the Treatment of Older Women with Breast Cancer

  • Daisy Neal

Student thesis: Doctoral Thesis


Despite NICE guidelines to treat breast cancer patients “irrespective of age”, older patients receive differential treatment and experience worse outcomes. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and perhaps perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as a factor in poorer outcomes for older breast cancer patients nor, consequentially, has removing age bias been considered as an approach for improving outcomes.

This thesis explores age bias towards older breast cancer patients through three empirical research studies, considering the questions: Is there evidence of age bias in breast cancer health care professionals’ treatment of older patients? Do interventions to address age bias lead to better quality decision making for the treatment of older women with breast cancer?

Study 1 explores implicit, explicit, and decision age bias amongst breast cancer health care professionals. The study finds that health care professionals do not consider themselves to be age biased but vary in what they consider age bias to be, hold negative implicit associations about older women, and deviate from standard treatment more often for older patients.

Studies 2 and 3 test interventions on age bias in decision making for older breast cancer patients. The studies find age bias interventions can facilitate better quality decision making for older patients, evidenced through decreased age-based decision making and increased efforts to include patients in decision making, and highlight the need to consider the role of dementia and decision making.

This thesis concludes that a focus on age bias offers a useful approach to improving treatment for older women with breast cancer, and that understanding what better-quality treatment looks like from the patients’ perspective would be a critical next step.
Date of AwardJun 2022
Original languageEnglish
Awarding Institution
  • University of Brighton
Supervisor Dr Jenna Morgan (Supervisor) & Tom Ormerod (Supervisor)

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