ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Defining Undertreatment and Overtreatment in Older Adults With Cancer: A Scoping Literature Review.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 8 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
99 citing papers in PubMed, 8 syntheses or guidelines pooled it, 169 citations in OpenAlex.
- Pharmacotherapy for older adults with cancer: a digest of the Japanese clinical practice guidelines (2nd edition)-general principles.International journal of clinical oncology · 2026Guideline
- Treatment decision-making and quality of life versus length of life preferences of older patients with early stage cancer: A systematic review.Journal of geriatric oncology · 2025Pooled it
- Epidemiology of cancer in older adults: a systematic review of age-related differences in solid malignancies treatment.Current oncology reports · 2025Pooled it
- Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Guideline
- Chemotherapy and gene expression profiling in older early luminal breast cancer patients: An International Society of Geriatric Oncology systematic review.European journal of cancer (Oxford, England : 1990) · 2022Pooled it
- Impact of Polypharmacy, Drug-Related Problems, and Potentially Inappropriate Medications in Geriatric Patients and Its Implications for Bulgaria-Narrative Review and Meta-Analysis.Frontiers in public health · 2022Pooled it
- Representation and Outcomes of Older Adults in Practice-Changing Oncology Trials in the Era of Novel Therapies: A Guideline Appraisal.Journal of the National Comprehensive Cancer Network : JNCCN · 2022Pooled it
- Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group.Journal of geriatric oncology · 2020Guideline
- Trial
- Trial
- Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies.Haematologica · 2022Trial
- Outcomes of older men receiving docetaxel for metastatic hormone-sensitive prostate cancer.Prostate cancer and prostatic diseases · 2021Trial
- Prevalence of and factors associated with treatment modification at first cycle in older adults with advanced cancer receiving palliative treatment.Journal of geriatric oncology · 2021Trial
- The effect of geriatric intervention in frail older patients receiving chemotherapy for colorectal cancer: a randomised trial (GERICO).British journal of cancer · 2021Trial
- Evaluation of Surgeon Attitudes Toward Frailty Screening in Breast Oncology Patients.Annals of surgical oncology · 2026Article
- Guideline concordance of stage IIIA non-small-cell lung cancer treatment in the Australian setting.Internal medicine journal · 2026Article
- Review
- Caring for Older Adults with Acute Myeloid Leukemia: Best Practices for Aligning Patient Fitness and Preference with Available Therapies.Drugs & aging · 2026Review
- Treatment Tolerability in Older Adults With Advanced Cancer Receiving Geriatric Assessment-Guided Versus Oncologist-Guided Primary Treatment Modification: Secondary Analysis of the GAP70+ Trial.JCO oncology practice · 2026Article
- Do non-responders of a geriatric screening questionnaire face lower one-year survival compared to responders? A retrospective cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
39 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
purposeThe terms undertreatment and overtreatment are often used to describe inappropriate management of older adults with cancer. We conducted a comprehensive scoping review of the literature to clarify the meanings behind the use of the terms.
methodsWe searched PubMed (National Center for Biotechnology Information), Embase (Elsevier), and CINAHL (EBSCO) for titles and abstracts that included the terms undertreatment or overtreatment with regard to older adults with cancer. We included all types of articles, cancer types, and treatments. Definitions of undertreatment and overtreatment were extracted, and categories underlying these definitions were derived through qualitative analysis. Within a random subset of articles, C.D. and K.P.L. independently performed this analysis to determine final categories and then independently assigned these categories to assess inter-rater reliability.
resultsArticles using the terms undertreatment (n = 236), overtreatment (n = 71), or both (n = 51) met criteria for inclusion in our review (n = 256). Only 14 articles (5.5%) explicitly provided formal definitions; for the remaining, we inferred the implicit definitions from the terms' surrounding context. There was substantial agreement (κ = 0.81) between C.D. and K.P.L. in independently assigning categories of definitions within a random subset of 50 articles. Undertreatment most commonly implied less than recommended therapy (148; 62.7%) or less than recommended therapy associated with worse outcomes (88; 37.3%). Overtreatment most commonly implied intensive treatment of an older adult in whom the harms of treatment outweigh the benefits (38; 53.5%) or intensive treatment of a cancer not expected to affect an older adult in his/her remaining lifetime (33; 46.5%).
conclusionUndertreatment and overtreatment of older adults with cancer are imprecisely defined concepts. We propose new, more rigorous definitions that account for both oncologic factors and geriatric domains.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.