Published online Mar 24, 2020. doi: 10.5306/wjco.v11.i3.152
Peer-review started: October 18, 2019
First decision: November 5, 2019
Revised: December 20, 2019
Accepted: January 1, 2020
Article in press: January 1, 2020
Published online: March 24, 2020
National cancer strategy calls for comprehensive assessments for older people but current practice across the United Kingdom is not well described.
To identify current assessment methods and access to relevant supporting services for older people with cancer.
A web-based survey (SurveyMonkey) targeting health professionals (oncologists, cancer surgeons, geriatricians, nurses and allied health professionals) was distributed January-April 2016 via United Kingdom nationally recognised professional societies. Responses were analysed in frequencies and percentages. Chi Square was used to compare differences in responses between different groups.
640 health care professionals responded. Only 14.1% often/always involved geriatricians and 52.0% often/always involved general practitioners in assessments. When wider assessments were used, they always/often influenced decision-making (40.5%) or at least sometimes (34.1%). But 30.5%-44.3% did not use structured assessment methods. Most clinicians favoured clinical history taking. Few used scoring tools and few wished to use them in the future. Most had urgent access to palliative care but only a minority had urgent access to other key supporting professionals (e.g. geriatricians, social workers, psychiatry). 69.6% were interested in developing Geriatric Oncology services with geriatricians.
There is variability in assessment methods for older people with cancer across the United Kingdom and variation in perceived access to supporting services. Clinical history taking was preferred to scoring systems. Fostering closer links with geriatricians appears supported.
Core tip: There was variability in assessment methods and access to supporting services for older people with cancer in the United Kingdom. Performance status and traditional history-taking was preferred to scoring tools. Future studies should consider moving away from scoring tools if the intention is for use in clinical practice. There was variability in access to key supporting services. Developing care pathways to better link up existing services would be helpful. Collaborative working with geriatricians appears supported. A number of questions remain. How can comprehensive geriatric assessment be feasibly embedded within cancer care pathways across a nation?