CGA

Q: What are the six domains of comprehensive geriatric assessment (CGA) in oncology patients?

Answer: More than half of the new cases and 70 percent of mortality from cancer occur in patients ≥65 years of age.

Many oncologists perform comprehensive geriatric assessments (CGAs) and make a shared decision about the extent of oncology treatment. 

Consensus guidelines from the American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the International Society for Geriatric Oncology (SIOG) recommend its use. Over time, there were many modifications done either individually by a physician or by practice groups, but overall, the following domains of CGA should be considered:

• Functional status
• Comorbidity
• Nutrition 
• Medication review
• Psychological state and social support
• Cognitive function

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References:

1. Decoster L, Van Puyvelde K, Mohile S, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations†. Ann Oncol 2015; 26:288.

2. Mohile SG, Dale W, Somerfield MR, Hurria A. Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology Summary. J Oncol Pract 2018; 14:442.

3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Older adult oncology. https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf 

4. Hurria A, Gupta S, Zauderer M, et al. Developing a cancer-specific geriatric assessment: a feasibility study. Cancer 2005; 104:1998.