Do non-responders of a geriatric screening questionnaire face lower one-year survival compared to responders? A retrospective cohort study

Purpose: A geriatric screening questionnaire was implemented in 2020 at the Department of Oncology, Gødstrup Hospital, Denmark, to identify frailty and individualize cancer care for all patients aged ≥ 60 years. However, not all patients answered. The primary aim of this study was to investigate the association between response status to the geriatric screening questionnaire and one-year survival. A secondary aim was to compare one-year survival according to the responders’ frailty status. Methods: We conducted a retrospective cohort study including all patients with cancer aged ≥ 60 who were enrolled in the geriatric screening between August 2020 and October 2023. The survival curves for responders and non-responders and across the patients’ frailty status were visualized using Kaplan–Meier plots. The associations were analyzed using logistic regression adjusted for potential confounders. Results: In total, 702 patients were included. Among these, 28.1% were non-responders, 46.7% were classified as high risk of frailty, and 25.2% as low risk of frailty. The non-responders had the lowest survival, which declined rapidly in the first 100 days. Survival was similarly lower among non-responders and responders at high risk of frailty, compared to responders at low risk. When adjusted for cohabiting status, age, and cancer type, the odds ratio of survival among non-responders compared to responders was 0.63 (95%CI: 0.42;0.92). Conclusion: The non-responders had the lowest survival, comparable to patients at high risk of frailty among the responders. Their survival declined rapidly suggesting that non-response may signal vulnerability and warrant closer clinical attention or early supportive care.