Abstract
Introduction
Geriatric screening and geriatric assessment (GS/GA) have proven their benefits in
the care for older patients with cancer. However, less is known about the predictive
value of GS/GA for outcomes. To research this, clinical data on GS/GA can be enriched
with population-based data. In this article we describe the methods and feasibility
of data linkage, and first clinical outcomes (GS/GA results and overall survival).
Materials and Methods
A large cohort study consisting of patients aged ≥70 years with a new cancer diagnosis
was established using linked data from clinical and population-based databases. Clinical
data were derived from a previous prospective study where older patients with cancer
were screened with G8, followed by GA in case of an abnormal result (GS/GA study;
2009–2015). These data were linked to cancer registration data from the Belgian Cancer
Registry (BCR), reimbursement data of the health insurance companies (InterMutualistic
Agency, IMA), and hospital discharge data (Technical Cell, TCT). Cox regression analyses
were conducted to evaluate the prognostic value of the G8 geriatric screening tool.
Results
Of the 8067 eligible patients with a new cancer diagnosis, linkage of data from the
GS/GA study and data from the BCR was successful for 93.7%, resulting in a cohort
of 7556 patients available for the current analysis. Further linkage with the IMA
and TCT database resulted in a cohort of 7314 patients (96.8%). Based on G8 geriatric
screening, 67.9% of the patients had a geriatric risk profile. Malnutrition and functional
dependence were the most common GA-identified risk factors. An abnormal baseline G8
score (≤14/17) was associated with lower overall survival (adjusted HR [aHR] = 1.62
[1.50–1.75], p < 0.001).
Discussion
Linking clinical and population-based databases for older patients with cancer has
shown to be feasible. The GS/GA results at cancer diagnosis demonstrate the vulnerability
of this population and the G8 score showed prognostic value for overall survival.
The established cohort of almost 8000 patients with long-term follow-up will serve
as a basis in the future for detailed analyses on long-term outcomes beyond survival.
Keywords
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Article info
Publication history
Published online: February 15, 2023
Accepted:
January 11,
2023
Received in revised form:
November 4,
2022
Received:
December 31,
2021
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
