Older people are far less likely to be given life-saving treatment than younger cancer patients but this does not mean they do not want it, a charity has warned.
Macmillan Cancer Support said there is no significant difference by age group or stage of cancer at diagnosis on the likelihood of people opting out of a certain treatment such as chemotherapy or radiotherapy.
It also found that while older people are confident in pursuing treatment, they are less likely to question decisions about which treatment might be best for them and the charity said it is concerned that older people are therefore missing out on the full range of different treatments available.
Previous research found younger cancer patients were more likely to have surgery for 19 cancer types, with the largest differences between age groups seen in kidney and ovarian cancers.
Cancer Research UK found that surgery was performed on almost three quarters (73%) of all kidney cancer patients aged between 15 and 54, but this halved to a third (36%) of patients aged between 75 and 84, and fell to just one in ten (11%) of patients over 85.
Macmillan Cancer Support said it has been suggested this is because older people may be more likely to turn down treatment, but said their latest research challenges this view.
They found that, when offered treatment, the vast majority of people will usually opt to receive it, with just 2% turning it down.
A further 14% have opted not to have certain treatments at some stage.
Jagtar Dhanda, head of inclusion at Macmillan Cancer Support, said: "Older people are simply not getting a fair deal when it comes to cancer care. We know they do not currently have the same access to cancer treatments or the same rates of survival as younger people.
"This research reveals, for the first time, that we would be wrong to assume that the reason for this is down to older people refusing cancer treatment more than younger patients.
"So the question now is - why are older people not getting the cancer treatment they need? We are worried judgments about older people are being made on the basis of their age rather than their actual capacity or preference to receive treatment. And we hope that this research will help to challenge this."
Les Scaife, 81, from Southport, Lancashire, was diagnosed with breast cancer a year ago.
He said: "I just went for a routine check up and was shocked when tests showed I had breast cancer. When they starting asking me questions about my age, I felt intimidated. I wondered if I'd get a lesser treatment if I said I was 81.
"When I told them that I'd rather they treat my symptoms, not my age, they said they had to make sure I was okay for an operation. Surely it's a matter of fitness, not age.
"I was reassured it wasn't an issue, but I do wonder if I'd not said anything whether things would have been different."
A spokesman for the Department of Health said: "It is entirely wrong to deny people treatment because of their age, which is why we made it illegal.
"We are absolutely clear - decisions about care should be based on clinical need."