Today I’m going to talk about the update on the recommendation guideline of the International Society of Geriatric Oncology on screening tools. I’m going to talk about it from the perspective of the nursing and the allied health professionals. Like we all know, geriatric assessment is a hot topic at this conference and also within this society. We know that it is standard of care to perform in all patients that are 70 years and older and we all know that it’s time well spent to do and perform a geriatric assessment but in very busy clinical daily practice sometimes people prefer to use a geriatric screening tool. We all know that the screening tool has several advantages to use in clinical practice. From the research point of view we know that the screening tool has some prognostic information related to overall survival, it also has predictive information for treatment related toxicities and, for example, functional decline in older patients with cancer. But from the clinical and really practical point of view a screening tool needs to be very brief, very short, very simple to complete, those are the main characteristics that are important for daily practice.
At this time-point what we see also described in the SIOG guidelines is the fact that there are many screening tools currently used in care for older patients with cancer. Very often these screening tools are very region or country specific, sometimes even hospital specific. So for nurses and allied health professionals it’s often really important to see and discover which screening tool in their region and hospital is well known because it’s easier to implement and use this kind of screening tool in their own clinical practice. But the main importance for this group of professionals is the fact that the screening tool is just the first step so nurses and allied health professionals have a crucial role in all the steps following on the use of a screening tool. So based on the result it is really important that they plan and make sure that a geriatric assessment is performed in people who have an abnormal result on the screening tool, no matter which screening tool it is, but a geriatric assessment needs to be following. Also the establishment of geriatric recommendations and the interventions and the follow-up of the older patients with cancer is very often the core business of nurses and allied health professionals in daily oncology practice.
So in this guideline that was published three years ago there is an overview of all different screening tools that are currently used. There nurses and allied health professionals can take a look at which one they know and which one they can select and implement in their clinical practice. That’s one of the major possibilities and one of the most important tasks that these professionals have in the care for older patients with cancer.
What kind of questions do you think will be asked about your talk?
The first question that I always receive is which screening tool we need to use. That’s the most difficult one because there are so many aspects on the screening tool that are important and that need to be taken into account when choosing one of them. So the only thing that we at this time-point know is that based on the research that has been performed in the past few years, and many research has come up in this field of geriatric oncology, the only thing that we know is which screening tools, like for example the G8 screening tool and the Flemish version of the triage risk screening tool are the two ones that are well established, well researched and investigated. Currently the characteristics of these screening tools are the most promising but they will never be perfect. So my main message about these kinds of things is very often that you will never find a perfect screening tool but it’s better to use a good one or to select one and implement it than do nothing at all.