Predicting Life Expectancy for Older Adults with Cancer in Clinical Practice: Implications for Shared Decision-making

Curr Oncol Rep. 2019 Jun 25;21(8):68. doi: 10.1007/s11912-019-0821-3.

Abstract

Purpose of review: The calculation of noncancer-specific life expectancy can guide shared decision-making and avoid over- and undertreatment in older adults with cancer. Several factors determine life expectancy, including socio-demographic background, comorbidities, physical performance, and geriatric assessment variables. We present an overview of existing tools to estimate life expectancy, as well as practical examples of how to take into account the patient's noncancer-specific life expectancy when discussing screening decisions, initiation of treatment, and end-of-life care.

Recent findings: Life expectancy prognostication has been recently recommended by international societies as part of the initial assessment of all older adults with cancer. Additionally, online resources have been created in order to make life expectancy calculation tools accessible for clinicians. Understanding available methods to estimate life expectancy, as well as how to utilize them, is a fundamental part of geriatric oncology that should be integrated into everyday clinical practice.

Keywords: Adjuvant chemotherapy; Benefit risk assessment; Cancer screening; Decision-making; End of life care; Geriatric assessment; Geriatrics; Life expectancy; Mortality; Neoplasms; Older adults; Survival analysis.

Publication types

  • Review

MeSH terms

  • Aged
  • Decision Making, Shared*
  • Early Detection of Cancer
  • Geriatric Assessment
  • Geriatrics / standards*
  • Humans
  • Life Expectancy*
  • Medical Oncology / standards*
  • Neoplasms / diagnosis
  • Neoplasms / therapy*
  • Prognosis