Nurse navigators successfully implemented geriatric and toxicity evaluations, resulting in a high rate of referrals for needed supportive services, according to results of a study presented at the 2022 ASCO Annual Meeting.

The cancer population is aging, and many older patients have urgent, unmet needs. Studies of geriatric or toxicity screening programs find low screening completion rates by physicians (20% to 35%).

To evaluate whether nurse navigators can successfully increase screening rates in a real-world setting, this pilot study was conducted at 7 community cancer centers in 2021. Nurses used the geriatric 8 (G8) screening tool in patients aged 65 years and older at all centers, and at 4 of the centers, patients receiving chemotherapy for solid tumors were also evaluated by the Cancer and Aging Research Group (CARG) toxicity tool. Referrals were sent by nurse navigators based on screening results.

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During the study period, 1372 patients were eligible for G8 and 563 for CARG screening, among whom 78.9% and 91.6% were evaluated, respectively.

The patients who were assessed were median age 74 years (range, 65 to 100), 52% were women, 51% were White, 23% were Asian or Pacific Islander, 15% were Black, and 8% were Hispanic. The most common cancers were genitourinary (18%), breast (17%), upper gastrointestinal (15%), and thoracic (13%) cancers.

Patients were referred for nutrition (193 referrals), audiology (30), physical therapy (18), psychiatry (5), and neurology (5) services.

Although, the researchers note that these findings may not be generalizable to other centers, these study results demonstrated that nurse navigators can facilitate G8 and CARG toxicity screening in the real-world setting and successfully refer patients to multiple supportive services, addressing an important unmet patient need.


Shaia JL, Liu R, Sun H, et al. Nurse navigator-initiated geriatric assessments in hematology/oncology clinics. J Clin Oncol. 2022;40(suppl 16; abstr 12051). doi:10.1200/JCO.2022.40.16_suppl.12051