Addressing geriatric oncology in Danish cancer guidelines to meet future challenges

INTRODUCTION. The risk of cancer increases with age. Furthermore, frailty and age-related impairments significantly impact treatment outcomes. With an aging population, it is crucial to ensure a tailored, evidence-based cancer care approach. This study evaluated the extent to which frailty and age-related considerations are incorporated into current Danish national cancer guidelines across six frequent cancer types. METHODS. We systematically reviewed all guidelines from the Danish Multidisciplinary Cancer Groups on lung, breast, colorectal, ovarian, bladder and prostate cancer. Guidelines were screened to identify how they address age, frailty, performance status (PS), comorbidity, functional status, general health status and individualised assessment. Identified comments were graded based on their level of specificity and clinical applicability. RESULTS. All cancer guidelines addressed age and comorbidity. Frailty was explicitly mentioned in four out of six, of which only one guideline provided specific recommendations. PS was frequently included (5/6), and individualised assessments were encouraged in four of six guidelines, but lacked clarity regarding implementation. CONCLUSIONS. Danish national cancer guidelines acknowledge age, PS and comorbidity, but lack specific recommendations for frailty assessment and management. By addressing these gaps, we encourage future guidelines to include recommendations on frailty assessment to help clinical decision-making and improve treatment outcomes for older people with cancer.