In May 2018, the American Society of Clinical Oncology (ASCO) published the first-of-its-kind clinical guideline focused on the assessment and management of vulnerabilities of older patients receiving chemotherapy and subsequently published an updated guideline in 2023. The guideline recommends the use of geriatric assessments (GAs) to capture vulnerabilities that are not routinely captured by typical oncology assessments and to inform personalized care in this patient population. GA is a collection of validated tools assessing specific domains of the patient (e.g., physical function, comorbidities, cognition) to be associated with worse outcomes. GA is the standard of care for assessing vulnerabilities in older patients with cancer to guide communications, treatment decision making, and care management. Importantly, randomized trial data shows that GA-guided therapy can reduce treatment toxicity, including negative impacts on function and quality of life.
Following the publication of this guideline, ASCO conducted a survey of its membership who are involved in patient care to understand their current knowledge of GAs and their use of GAs in clinical practice for patients aged 65 and over. The survey found that awareness of the ASCO guideline was associated with increased use of GAs. While most oncologists recognized the importance of specialized evaluations in the management of older adults, most respondents (69%) reported relying on subjective, informal assessments and only 20% of oncologists reported consistent GA use as recommended by the ASCO guideline. The survey also identified multiple barriers to the use of the GA, including minimal resources, limited knowledge and training, lack of awareness of existing tools, and uncertainty about how to use the tools.
To help increase the awareness and utilization of GAs in oncology care, the following resources have been curated.
Educational Tools & Resources
- Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update
- Infographic summarizing the benefits of utilizing Geriatric Assessment for patients with cancer
- Action Chart for Practical Geriatric Assessment
- Practical Geriatric Assessment
- VIDEO: How to Do a Geriatric Assessment
- VIDEO: What to Do with the Results of a Geriatric Assessment