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Comprehensive Geriatric Assessment for Older Patients With Cancer

Martine Extermann, Arti Hurria

From the H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; and The City of Hope, Duarte, CA

Address reprint requests to Martine Extermann, MD, Senior Adult Oncology, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL 33612; e-mail: extermann{at}moffitt.usf.edu

Purpose: During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer.

Methods: In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions.

Results: The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Accumulating data show the benefits of incorporating a CGA in the evaluation of older patients with cancer. Prospective trials evaluating the utility of a CGA to guide interventions to improve the quality of cancer care in older adults are justified.

Conclusion: Growing evidence demonstrates that the variables examined in a CGA can predict morbidity and mortality in older patients with cancer, and uncover problems relevant to cancer care that would otherwise go unrecognized.

Supported by K23 AG026749-01 (Paul Beeson Career Development Award in Aging Research) and American Society of Clinical Oncology-Association of Specialty Professors-Junior Development Award in Geriatric Oncology (A.H.).

M.E. and A.H. contributed equally to this work.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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