Long-term outcomes in older patients with cancer and the association with geriatric screening and assessment results

Oncology care is tumour-centric by tradition, but especially in older patients, a more holistic approach is needed that takes into account each aspect of the patient’s health status and not just the tumour. Identifying areas of vulnerability with geriatric screening (GS) and/or geriatric assessment (GA) is crucial in providing patient-oriented and multidisciplinary care that is tailored to the patient’s general health status. The results of GS/GA allow the treating physician to apply clinical judgment based on an estimate of biological age to optimise cancer treatment decisions. The use of GS/GA is, however, not yet widespread in Belgian oncology practice so further evidence on what GS/GA results can contribute, particularly regarding long-term outcomes, was needed to further stimulate the systematic implementation. This study specifically aimed to explore the association between the GS (with Geriatric 8 or G8) / GA and long-term outcomes using linked clinical and population-based data from a cohort of older patients with cancer. It was demonstrated that older patients with an abnormal G8 score at cancer diagnosis had a significantly lower 10-year overall survival compared to patients with a normal G8 score. Furthermore, patients with an abnormal baseline G8 score displayed higher healthcare utilisation across primary care, hospital care, and residential care in the three years after cancer diagnosis. In deceased patients with an abnormal baseline G8 score, functional and cognitive impairment identified with GA at cancer diagnosis was associated with less specialised palliative care use in the last three months of life.