Use of Geriatric Assessments in Cancer Care: An Umbrella Review
A partir d'une revue de la littérature (29 revues), cette étude analyse les outils de prise en charge et d'évaluation gériatrique en cancérologie
Background: Geriatric assessments (GAs) can guide treatment decision-making for older adults with cancer and identify those at risk of treatment complications. Given the number of systematic reviews conducted in the last 10 years, this umbrella review aimed to summarise and synthesise the evidence for (i) what constitutes a GA in cancer care, (ii) how GAs are conducted, and (iii) how implementation of GAs in cancer settings are reported.
Methods: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Library and Web of Science databases were searched and updated in September 2024. Systematic reviews with or without meta-analyses that (i) described the use or value of GA for older adults with cancer, or (ii) information related to GA implementation in cancer settings were included in this review. Quality of the reviews were assessed using the AMSTAR-2 tool, and results were descriptively summarised using a narrative synthesis.
Results: Twenty-nine reviews were included. A GA was commonly defined as a systematic, multidimensional evaluation of an older person. Recommendation for domains included within the GA differed across reviews. However, commonly reported domains and tools across reviews broadly mapped to the National Comprehensive Cancer Network guideline recommendations. Fifteen reviews specified timing of GA; most reported assessments were performed prior to treatment and administered by a range of individuals including patient themselves, the multi-disciplinary team, individual nurse or cancer specialists or geriatrician-led consultation or assessments. Barriers and enablers to GA implementation were discussed in three reviews. Four reviews described GA feasibility, primarily reporting patient acceptability of self-administered or computer-based assessments.
Discussion: Heterogeneity across reviews in GA definition could impact on perceived feasibility of GA implementation. Standardisation of GA domains is required to facilitate evidence-based research and to guide integration of GA and GA-based interventions within cancer settings.
European Journal of Cancer Care , article en libre accès, 2025