Hamaker ME, Jonker JM, de Rooij SE, Vos AG, Smorenburg CH, van Munster BC
Lancet Oncol 2012;13:e437-44
Publication date: October 1, 2013
In older patients with cancer, pre-screening may be used to identify fit patients who are able to receive standard treatment and patients in whom a full comprehensive geriatric assessment (CGA) should be done to detect vulnerability so that treatment can be adjusted accordingly.
Hamaker et al. performed a systematic review with the aim to determine which of the frailty screening methods available show the best sensitivity and specificity for predicting the presence of impairments on CGA in elderly patients with cancer. Seven different frailty screening methods were assessed.
The median sensitivity and specificity of each screening method for predicting frailty on CGA were as follows: Vulnerable Elders Survey-13 (VES-13), 68% and 78%; Geriatric 8 (G8), 87% and 61%; Triage Risk Screening Tool (TRST 1+; patient considered frail if one or more impairments present), 92% and 47%, Groningen Frailty Index (GFI) 57% and 86%, Fried frailty criteria 31% and 91%, Barber 59% and 79%, and abbreviated CGA (aCGA) 51% and 97%. G8 and TRST 1+ had the highest sensitivity for frailty, but both had poor specificity and negative predictive value.
The authors conclude that, for now, it might be beneficial for all elderly patients with cancer to receive a complete geriatric assessment.