Relevance of a systematic geriatric screening and assessment in older patients with cancer: results of a prospective multicentric study.

BACKGROUND To evaluate the large-scale feasibility and usefulness of geriatric screening and assessment in clinical oncology practice by assessing the impact on the detection of unknown geriatric problems, geriatric interventions and treatment decisions. PATIENTS AND METHODS Eligible patients who had a malignant tumour were ≥70 years old and treatment decision had to be made. Patients were screened using G8; if abnormal (score ≤14/17) followed by Comprehensive Geriatric Assessment (CGA). The assessment results were communicated to the treating physician using a predefined questionnaire to assess the topics mentioned above. RESULTS One thousand nine hundred and sixty-seven patients were included in 10 hospitals. Of these patients, 70.7% had an abnormal G8 score warranting a CGA. Physicians were aware of the assessment results at the time of treatment decision in two-thirds of the patients (n = 1115; 61.3%). The assessment detected unknown geriatric problems in 51.2% of patients. When the physician was aware of the assessment results at the time of decision making, geriatric interventions were planned in 286 patients (25.7%) and the treatment decision was influenced in 282 patients (25.3%). CONCLUSION Geriatric screening and assessment in older patients with cancer is feasible at large scale and has a significant impact on the detection of unknown geriatric problems, leading to geriatric interventions and adapted treatment.

[1]  S. Mathoulin-Pélissier,et al.  Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[2]  H. Wildiers,et al.  Comprehensive geriatric assessment (CGA) in older oncological patients: Why and how? , 2012 .

[3]  S. Culine,et al.  Comprehensive geriatric assessment in the decision-making process in elderly patients with cancer: ELCAPA study. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  J. Pierga,et al.  Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients? , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[5]  S. Mathoulin-Pélissier,et al.  Validation of a screening test for elderly patients in oncology , 2008 .

[6]  A. Sinclair,et al.  The geriatric minimum data set for clinical trials (GMDS) , 2008, The journal of nutrition, health & aging.

[7]  H. Wildiers,et al.  19 The Flemish version of the Triage Risk Screening Tool (TRST): a multidimensional short screening tool for the assessment of elderly patients , 2006 .

[8]  J. Slaets,et al.  Vulnerability in the elderly: frailty. , 2006, The Medical clinics of North America.

[9]  H. Cohen,et al.  Developing a cancer‐specific geriatric assessment , 2005, Cancer.

[10]  H. Cohen,et al.  Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). , 2005, Critical reviews in oncology/hematology.

[11]  G. Hortobagyi,et al.  Breast cancer treatment guidelines in older women. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  G. Vlastos,et al.  Undertreatment strongly decreases prognosis of breast cancer in elderly women. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  S. Sternberg THE VULNERABLE ELDERS SURVEY: A TOOL FOR IDENTIFYING VULNERABLE OLDER PEOPLE IN THE COMMUNITY , 2003, Journal of the American Geriatrics Society.

[14]  W. Haley,et al.  A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. , 2004, Critical reviews in oncology/hematology.

[15]  M. Aapro,et al.  Evaluation of the elderly with cancer. , 2000, Annals of oncology : official journal of the European Society for Medical Oncology.