A majority of cancer cases now occur among older people, but this group is less likely to receive treatment and outcomes are poorer than in younger people. Age by itself can be a poor predictor of who will benefit from treatment with surgery, chemotherapy or radiotherapy. Comprehensive geriatric assessment is a multidisciplinary, multidomain process that helps to identify frailty, which is associated with increased mortality. Comprehensive geriatric assessment highlights areas that should be optimized before treatment and helps support a shared decision-making approach. Geriatricians, oncologists and surgeons now work together to help assess and support older people with cancer.
The ageing population poses new challenges globally. Cancer care for older patients is one of these challenges, and it has a significant impact on societies. In the United Kingdom (UK), as the number of older cancer patients increases, the management of this group has become part of daily practice for most oncology teams in every geographical area. Older cancer patients are at a higher risk of both under-and over-treatment. Therefore, the assessment of a patient's biological age and effective organ functional reserve becomes paramount. This may then guide treatment decisions by better estimating a prognosis and the risk-to-benefit ratio of a given therapy to anticipate and mitigate against potential toxicities/difficulties. Moreover, older cancer patients are often affected by geriatric syndromes and other issues that impact their overall health, function and quality of life. Comprehensive geriatric assessments offer an opportunity to identify and address health problems which may then optimise one's fitness and well-being. Whilst it is widely accepted that older cancer patients may benefit from such an approach, resources are often scarce, and access to dedicated services and research remains limited to specific Review
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