Geriatric assessment for older people with cancer: policy recommendations

Seghers, P. A.L.; Alibhai, Shabbir M.H.; Battisti, Nicolò Matteo Luca; Kanesvaran, Ravindran; Extermann, Martine; O’Donovan, Anita; Pilleron, Sophie; Mislang, Anna Rachelle; Musolino, Najia; Cheung, Kwok-Leung; Staines, Anthony; Girvalaki, Charis; Soubeyran, Pierre; Portielje, Johanneke E.A.; Rostoft, Siri; Hamaker, Marije E.; Trépel, Dominic; O’Hanlon, Shane

Abstract

Most cancers occur in older people and the burden in this age group is increasing. Over the past two decades the evidence on how best to treat this population has increased rapidly. However, implementation of new best practices has been slow and needs involvement of policymakers. This perspective paper explains why older people with cancer have different needs than the wider population. An overview is given of the recommended approach for older people with cancer and its benefits on clinical outcomes and cost-effectiveness. In older patients, the geriatric assessment (GA) is the gold standard to measure level of fitness and to determine treatment tolerability. The GA, with multiple domains of physical health, functional status, psychological health and socio-environmental factors, prevents initiation of inappropriate oncologic treatment and recommends geriatric interventions to optimize the patient’s general health and thus resilience for receiving treatments. Multiple studies have proven its benefits such as reduced toxicity, better quality of life, better patient-centred communication and lower healthcare use. Although GA might require investment of time and resources, this is relatively small compared to the improved outcomes, possible cost-savings and compared to the large cost of oncologic treatments as a whole.

Citation

Seghers, P. A., Alibhai, S. M., Battisti, N. M. L., Kanesvaran, R., Extermann, M., O’Donovan, A., …O’Hanlon, S. (2023). Geriatric assessment for older people with cancer: policy recommendations. Global Health Research and Policy, 8(1), Article 37. https://doi.org/10.1186/s41256-023-00323-0

• Journal Article Type: Article
• Acceptance Date: Aug 21, 2023
• Online Publication Date: Sep 1, 2023
• Publication Date: 2023
• Deposit Date: Sep 7, 2023
• Journal: Global Health Research and Policy
• Electronic ISSN: 2397-0642
• Publisher: Springer Nature
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 1
• Article Number: 37
• DOI: https://doi.org/10.1186/s41256-023-00323-0
• Keywords: Geriatric assessment, Shared, Toxicity, Medical oncology, Quality of life, 80 and over, Aged, Survival, Decision making, Health policy, Neoplasms
• Public URL: https://nottingham-repository.worktribe.com/output/25058148
• Publisher URL: https://ghrp.biomedcentral.com/articles/10.1186/s41256-023-00323-0
• Additional Information: Received: 15 March 2023; Accepted: 21 August 2023; First Online: 1 September 2023; : ; : Not applicable.; : All authors provide their consent.; : Nicolò Matteo Luca Battisti: Advisory board: Pfizer, Abbott, Sanofi; Travel grants: Exact Sciences, Pfizer, Lilly; Speaker fees: Pfizer, AbbVie, Roche, Sanofi; Kwok-Leung Cheung: I have provided consultancy to Roche. All other authors: No competing interests to declare.