Identifying an accurate pre-screening tool in geriatric oncology

Kellen, Eliane; Bulens, Paul; Deckx, Laura; Schouten, Harry; Van Dijk, Marjan; Verdonck, Ilse; Buntinx, Frank

doi:10.1016/j.critrevonc.2009.12.002

« Previous Next »Critical Reviews in Oncology / Hematology
Volume 75, Issue 3 , Pages 243-248, September 2010

Identifying an accurate pre-screening tool in geriatric oncology

Eliane Kellen
- Leuven Centre of Cancer Prevention, University Hospitals - Leuven, Belgium
- Corresponding author at: Leuven Centre of Cancer Prevention, University Hospitals - Leuven, Belgium. Tel.: +32 016 33 74 93; fax: +32 016 33 74 80.
Paul Bulens
- Limburg Oncology Centre – Hasselt, Belgium
Laura Deckx
- Department of General Practice and Research Institute Caphri, Maastricht University, The Netherlands
Harry Schouten
- Department of Internal Medicine, Section Hematology/Oncology, Academic Hospital Maastricht, The Netherlands
Marjan Van Dijk
- Department of Internal Medicine, Section Oncology, Academic Hospital Maastricht, The Netherlands
Ilse Verdonck
- Limburg Oncology Centre – Hasselt, Belgium
Frank Buntinx
- Leuven Centre of Cancer Prevention, University Hospitals - Leuven, Belgium
- Department of General Practice and Research Institute Caphri, Maastricht University, The Netherlands

Accepted 10 December 2009. published online 08 January 2010.

Abstract

The use of comprehensive geriatric assessment (CGA) in cancer patients older than 70 is recommended. Three pre-screening instruments have been proposed: the abbreviated comprehensive geriatric assessment (aCGA), the Vulnerable Elders Survey (VES-13), and the Groningen frailty index (GFI). The objective of the study was to identify the most efficient pre-screening tool that accurately determines individuals who may benefit from the entire CGA. A total of 113 elderly cancer patients were assessed by means of the aCGA, VES-13, GFI and the full CGA. The sensitivity, specificity of the three instruments was calculated, using the results from the entire CGA as the gold standard for the GFI and the VES-13. The aCGA was assessed whether each sub-component reliably predicts impairment on each sub-component of the full CGA.

The majority of the participants were defined as being at risk of vulnerability: 68.14% had two or more impairments of the CGA or were cognitively impaired. The physical and disability questions are useful, but all other screening instruments miss too many cases.

Keywords: Geriatric oncology, Frail elderly, Geriatric assessment