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This study provides guidance for assessing geriatric needs in older cancer patients in resource-limited settings. It adapts existing guidelines to ensure essential geriatric assessments inform cancer care plans.

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Area of Science:

  • Geriatric Oncology
  • Global Health Equity
  • Clinical Guideline Adaptation

Background:

  • Older adults with cancer represent a growing population globally.
  • Resource-constrained settings face challenges in providing comprehensive geriatric care.
  • Existing oncology guidelines often assume maximal resource availability.

Purpose of the Study:

  • To adapt maximal-setting oncology guidelines for geriatric needs assessment in resource-limited environments.
  • To provide clinicians and policymakers with tools for evaluating older cancer patients (65+ years).
  • To ensure geriatric assessment informs cancer treatment plans when resources are scarce.

Main Methods:

  • Multidisciplinary, multinational expert panel convened.
  • Reviewed existing American Society of Clinical Oncology (ASCO) guidelines.
  • Employed modified ADAPTE and formal consensus processes for adaptation.

Main Results:

  • An ASCO resource-neutral guideline was successfully adapted for resource-constrained settings.
  • Recommendations achieved ≥75% agreement through formal consensus.
  • The adapted guideline emphasizes essential geriatric assessment domains.

Conclusions:

  • Endorses geriatric assessment (GA) to identify vulnerabilities in older cancer patients.
  • GA-guided management is crucial for patients with identified deficits receiving systemic therapy.
  • Recommends brief geriatric screening tools, with flexibility for validated local alternatives.
  • Cutoffs for GA-identified deficits may differ based on local validation and practice.