Older cancer patients aged 75 years or above are at risk of significant chemotherapy related toxicities. A need for screening these patients in our institution was identified based on internal morbidity and mortality data review. A pilot geriatric assessment screening programme was initiated to evaluate its feasibility and to identify older patients at risk of chemotherapy toxicities over a period of 12 months.
Between May 2017 and April 2018, all new patients seen at the Cancer Clinic at Flinders Medical Centre over 70 years old were screened using Geriatric 8 (G8) questionnaire. Patients with a G8 score of < 14, age > 75 years and planned to have chemotherapy were referred for a comprehensive geriatric assessment (CGA) by a geriatrician. ECOG performance status, cancer diagnosis and treatment related adverse events were also recorded.
713 referrals were received, 189 (27%) patients were identified to be > 75 years and 61 (9%) patients in this group received chemotherapy for cancer (range of cancer types including lung, gastrointestinal, genitourinary). G8 score < 14 was identified in 8 (4%) patients and 3 patients were referred for CGA. 29 (15%) patients in age group >75 years required dose reductions due to toxicity and there were 2 treatment related deaths due to neutropenic sepsis. Barriers to screening and to CGA were identified in this pilot study and will be further explored
Screening for older cancer patients at risk of treatment related toxicities is feasible. Potential barriers have been identified and will be presented in detail along with data on demographics, cancer type and treatment received.