Implementing Standardized Geriatric Screening Tools in Elderly Breast and Gynecologic Cancer Patients

Abstract

Problem Statement: Despite an aging patient population, geriatric assessment was not routinely used at the Kapiʻolani Women's Cancer Center. A standardized workflow considering resource and time limitations was needed to evaluate geriatric vulnerabilities before starting antineoplastic therapy.Purpose: To implement a standardized process for identifying patients needing a comprehensive geriatric assessment (CGA) and at increased risk for chemotherapy toxicity. Methods: The Geriatric 8 (G8) and the Cancer and Aging Research Group Chemotherapy Toxicity Tool (CARG) were administered alongside a standard clinical assessment for breast and gynecologic patients with cancer, ages 70 and older who were starting a new regimen of antineoplastic therapy. A post-implementation chart review was conducted to identify the number of patients screened over a three month period. Results: Three out of six eligible patients were assessed with the G8 and CARG. One patient had an abnormal G8 score, and another patient had a moderate CARG score. Discussion: The goal of initiating a standardized workflow for geriatric screening and chemotherapy toxicity risk was met. Due to the small sample size, further investigation is needed to assess the impact of the tools on provider practice.