Elsevier

Annals of Oncology

Volume 26, Issue 2, February 2015, Pages 288-300
Annals of Oncology

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

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ABSTRACT

Based on a systematic literature review, the screening tools task force of SIOG states that screening tools do not replace geriatric assessment in older cancer patients. However, in a busy clinical practice the use of such a tool is recommended to identify those patients in need of further evaluation and multidisciplinary approach. Further research remains necessary.

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.

Key words

screening tools
older cancer patients
geriatric assessment

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Previous presentation: This manuscript has been presented orally at the 13th conference of the International Society of Geriatric Oncology (SIOG) on the 26 October 2013 in Copenhagen, Denmark, and as a poster presentation at the 37th Winter meeting of the Belgian Society of Gerontology and Geriatric Medicine (BVGG), 21 February 2014, Oostende, Belgium.