Infancy of an Australian geriatric oncology program-characteristics of the first 200 patients

Objectives: The aging population brings with it increased cancer related morbidity and mortality. Comprehensive Geriatric Assessment (CGA) identifies areas of concern for the older patient with cancer that may not be detected with traditional oncological methods of assessment. However CGA is resource intensive and thus screening tools have been developed. Having developed a screening tool, we present the characteristics of the first 200 patients seen by our geriatric oncology clinic. Materials and methods: All patients aged 70 and over were invited to complete a self-reported screening questionnaire at time of referral to oncology services, covering domains addressed by the CGA. These questionnaires were then reviewed at a weekly multidisciplinary meeting. From this, five key measures, supplemented by medical chart review and clinical impression, were used to classify patients into fit, vulnerable or frail categories. Results: For the first 200 patients, the average age was 76.7. years, and 54% were male. The majority were community living, and 72% were being treated palliatively. Twenty-eight percent were classified fit, 60% vulnerable, and 13% frail. The fit, vulnerable and frail groups differed significantly in comorbidities, polypharmacy, memory concerns, falls, weight loss, physical function and exhaustion. Conclusion: Elderly patients referred to an Australian geriatric oncology program are a heterogenous group. The use of a screening tool for geriatric assessment was a feasible and acceptable method for assessing older patients with cancer. Further work is required to examine the prognostic value of classifying patients into fit, vulnerable and frail.