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hundred thousand people per year; in the over 70 is more than

50%, mainly prostate for men and breast cancer for women.

As result of these data, in Italy the interest for geriatric

oncology is constantly increasing. A recent survey carried

out among the Italian oncologists pointed out that, although

a specific care pathway for the elderly patient is available

only in 10% of the Oncology Departments, approximately

95% of oncologists acknowledges the vital importance of an

appropriate evaluation of the functional status for the older

patient with cancer. In this sense, some experiences like

those of Regione Piemonte and Regione Lombardia Local

Health Units are ongoing in Italy.

As regard of the international clinical research scenario,

several Italian oncologists are active members of the ETF

(Elderly Task Force) of the EORTC (European Organisation for

Research andTreatment of Cancer) and they actively take part

in some clinical protocols carried out by this task force.

In Italy the role of geriatric oncology is recently becoming

more evident, as pointed out by the involvement of GIOGer

(Italian Group of Geriatric Oncology) as founding partner of

the FICOG (Federation of the Italian Cooperative Oncology

Groups) and by the availability of a specific chapter of geriatric

oncology in the guidelines of AIOM (Italian Association of

Medical Oncology).

Disclosure of interest:

None declared


Romain Corre

CHU Pontchaillou Pneumology, Rennes, France

The speaker abstract has not been received at the time of







Jean-Pierre Droz

Centre Léon-Bérard, Environment and Cancer Reasearch Unit, Lyon,



Management of cancer in tropical areas

is characterized by a small proportion of elderly patients,

different cancer epidemiology (virus induced cancers),

advanced diseases and often low or intermediate incomes

countries. Cancer patients managed at the Saint-Laurent

Hospital, French Guiana, are representative of these

characteristics except that the health care system is the same

than in main France.


1) To describe elderly cancer patients’ manage-

ment at the Saint-Laurent Hospital, French Guiana, focusing

on health status screening and difficulties which were

encountered. 2) To translate the possible solutions to low and

intermediate income countries.


Elderly patients (pts) (age >70 years) were pros-

pectively identified among all new pts between 01/09/2014

and 31/05/2016. Elderly pts’ frailty screening was prospectively

performed based on the G8 tool and assessment in health

status groups based on Activity daily Living (ADL), Cumulative

Illness Score Rating-Geriatrics (CISR-G) and malnutrition

(weight loss). Pts and cancer characteristics were collected:

age, sex, language, nationality, medical coverage, and

primary tumor, extension (local-L, locally advanced-LA and



Twenty-three out of 111 new cancer pts (20%)

were aged more than 70 years. There were 10 women and 13

men. Median age was 76 years (extremes 70–94 years). There

were 14 French, 7 Surinamese, 2 Haitian pts. Language was:

Sranantongo 10 pts, French 7 pts, Creole 4 pts and Hmong 2

pts. Ten patients benefited from the National Health Security,

7 of Emergency Medical Assistance, 5 of Universal Medical

Coverage and one had no medical coverage. Cancer extension

was: L 3 pts, LA 10 pts, M 10 pts.

G8 screening tool value was 0 to 16 and only 6 pts had a

value >14. Health groups were: fit 4 pts, frail 9 pts, disabled/

severe comorbidities 7 pts and too sick 3 pts. Dementia was

present in 3 pts. The item “self-rated health” was difficult to

assess in 15 pts, due to lack of understanding and wording

(rated 0.5: “don’t know”). Correlation between G8 and

components of Health Status is poor. Correlation between

cancer extension and G8 and health status groups is poor.

The following problems emerge from these observations:

cancers are diagnosed at advanced stage, the treatment

being palliative, a screening tool as G8 is difficult to apply

due to cultural specificities which preclude the use of a

questionnaire and Western concepts of health. Therefore

clinical assessments, which can be performed by a health

professional, seem more appropriate (comorbidities, very

frequent in older in this setting, evaluation of ADL, measure

of BMI and albumin).

Additionally in low and intermediate income countries:

limitation to treatment access is important. Considering

treatment the most important is the access to potent

analgesics, to radiotherapy which is the best palliative

treatment. Use of medical treatment is difficult due to the

cost and wide difficulty to manage complications. An accurate

evaluation of risk/benefit/cost may help to include patients

in drug-access programs. Another important aspect of public

health is to promote prevention and more immediately

effective, early diagnosis. This implies a strong effort in

education and a proximity health professional networking.


geriatric oncology has an increasing impor-

tance in low and intermediate incomes countries but must

be adapted to the economy, health organization and cultural

differences. Health status can be screened easily through

medical assessment by well-trained health professional.

Palliative treatments are the first present priority. Prevention

and early diagnosis are the most important objectives to

develop in the near future.This can be done through education

which requires transcultural mediation to make possible the

appropriation of these concepts by people of non-western