Abstract 1347P
Background
Cancer patients treated in the Brazilian Public Health System (BSUS) frequently experience difficulties having access to specialized oncologic treatment in less than 60 days past their initial cancer diagnosis. It is believed in the medical community that older patients with cancer (OPWC) treated in the BSUS represent a more vulnerable population as compared to OPWC treated in the Brazilian private health system (BPHS). Our Oncology unit receives patients from both the BSUS and the BPHS. Consequently, we are in a crossroads position to use geriatric evaluations in OPWC of public and private health systems. All patients of BSUS benefit from an geriatric hyper-pragmatic assessment consisting of a 4-meter gait speed and cognitive screening by the MINI-COG test. All patients in the private system also receive these evaluations. Using an geriatric hyper-pragmatic assessment, we decided to evaluate possible differences in physical function (through 4 meters gait speed test) and risk of cognitive impairment (through Mini-Cog TEST) between the BSUS and BPHS populations of OPWC.
Methods
From January 2019 to March 2022, 905 patients older patients (>60 years old), 691 from BSUS and 214 from BPHS were evaluated by a 4-meter Gait speed (GS) and Mini-Cog tests prior to the first oncology consultation.
Results
Overall, 905 patients > 60 years old were evaluated. The mean age was 70 years (range 60-94), and 45% of patients were women. Mean GS was 0,89 m/sec in the BSUS and 0.93 m/sec in the BPHS, (P=0,042). This statistical difference in Gait speed is concentrated on the male population (0,9 m/sec vs 0,99 m/sec, P=0.0042). There is no difference in the female population regarding GS. Positive screening MINI-COG test was present in 48% of BSUS compared to 38% of BPHS patients (P<.05). This statistically positive difference concentrates on the female population, P=0.03.
Conclusions
A Hyper-pragmatic Geriatric Evaluation can detect sex-related specific vulnerabilities in the social strata of the Brazilian cancer population. The male population of OPWC treated in the BSUS has lower gait speed than BPHS patients. Regarding the risk of cognitive deficit, the female OPWC in the BSUS are particularly vulnerable and deserve double attention.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.