Background: The incidence of cancer increases with age (1). Incorporation of Comprehensive Geriatric Assessment (CGA) into older people with cancer is recommended by several international oncology guidelines, with evidence for increased oncology treatment completion, decreased treatment toxicity and improved patient centred outcomes (2,3). Despite this, implementation of Geriatric Oncology into mainstream practice has been slow (4).
The Sir Charles Gairdner Hospital (SCGH) Geriatric Oncology was established in 2020 and provides CGA to older patients with cancer.
Aims: Describe demographics and clinical characteristics of patients referred to the clinic, and measure new diagnoses and interventions following CGA.
Methods: A retrospective review of medical records was conducted for all new patients seen in the SCGH Geriatric Oncology clinic between 1st Jan and 31st August 2022.
Results: 29 patients were seen for CGA. The mean age was 73.93 years. Most patients had metastatic disease (68.97%) and were receiving chemotherapy or chemoradiotherapy (55.17%). The median Eastern Cooperative Oncology Group (ECOG) performance scale was 2, and the median Clinical Frailty Scale (CFS) score was 5. Geriatric interventions (defined as new diagnoses, referrals, advanced care planning discussions or medication changes) occurred in 25 (86.20%) patients.
Conclusion: Patients referred were generally mildly frail, with at least two comorbidities and two geriatric syndromes. The high median CFS score and large proportion of patients receiving geriatric interventions in our cohort suggests that there is a cohort of vulnerable patients that are not referred for CGA. Implementation of a frailty screening tool in the Medical Oncology clinic may be useful to guide referrals.