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Ann Oncol. 2015 Feb;26(2):288-300. doi: 10.1093/annonc/mdu210. Epub 2014 Jun 16.

Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations†.

Author information

  • 1Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels lore.decoster@uzbrussel.be.
  • 2Department of Geriatric Medecine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
  • 3Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, USA.
  • 4Department of Internal Medicine II, Jena University Hospital, Jena, Germany.
  • 5Department of Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova.
  • 6Department of Geriatric Medicine, Università Cattolica Sacro Cuore, Rome, Italy.
  • 7Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
  • 8Ohio State University Comprehensive Cancer Center, College of Nursing, Columbus, USA.
  • 9Department of General Medical Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
  • 10Border Medical Oncology, Wodonga, Australia.
  • 11Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, USA.
  • 12Department of Medical Oncology, National Cancer Centre Singapore, Singapore.
  • 13Division of Medical Oncology, S. Paolo Hospital, Milan, Italy.
  • 14Department of Medical Oncology, Centre Léon-Bérard, Lyon, France.
  • 15Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, USA.
  • 16Department of General Medical Oncology and Geriatric Medecine, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
  • 17Department of Surgery, University of Liverpool, St Helens Teaching Hospital, Liverpool, UK.
  • 18Moffitt Cancer Center, University of South Florida, Tampa, USA.

Abstract

BACKGROUND:

Screening tools are proposed to identify those older cancer patients in need of geriatric assessment (GA) and multidisciplinary approach. We aimed to update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on the use of screening tools.

MATERIALS AND METHODS:

SIOG composed a task group to review, interpret and discuss evidence on the use of screening tools in older cancer patients. A systematic review was carried out and discussed by an expert panel, leading to a consensus statement on their use.

RESULTS:

Forty-four studies reporting on the use of 17 different screening tools in older cancer patients were identified. The tools most studied in older cancer patients are G8, Flemish version of the Triage Risk Screening Tool (fTRST) and Vulnerable Elders Survey-13 (VES-13). Across all studies, the highest sensitivity was observed for: G8, fTRST, Oncogeriatric screen, Study of Osteoporotic Fractures, Eastern Cooperative Oncology Group-Performance Status, Senior Adult Oncology Program (SAOP) 2 screening and Gerhematolim. In 11 direct comparisons for detecting problems on a full GA, the G8 was more or equally sensitive than other instruments in all six comparisons, whereas results were mixed for the VES-13 in seven comparisons. In addition, different tools have demonstrated associations with outcome measures, including G8 and VES-13.

CONCLUSIONS:

Screening tools do not replace GA but are recommended in a busy practice in order to identify those patients in need of full GA. If abnormal, screening should be followed by GA and guided multidisciplinary interventions. Several tools are available with different performance for various parameters (including sensitivity for addressing the need for further GA). Further research should focus on the ability of screening tools to build clinical pathways and to predict different outcome parameters.

KEYWORDS:

geriatric assessment; older cancer patients; screening tools

PMID:
24936581
DOI:
10.1093/annonc/mdu210
[PubMed - indexed for MEDLINE]
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