Utility of the Edmonton Frail Scale in identifying frail elderly patients during treatment of colorectal cancer

Colorectal cancer (CRC) is one of the leading causes of death, and 70% of all cancer mortality occurs in patients that are 65 years and older (1). Elderly patients are at higher risk of complications from treatments, both due to impaired tolerability of chemotherapy and co-morbidities. Age has been associated with pharmacokinetic and pharmacodynamic changes that may increase susceptibility to toxicity (2). Clinical trials often fail to enroll representative numbers of elderly patients, in part due to the difficulties of these patients meeting strict eligibility criteria (3). Consequently, oncologists are often wary of treating elderly patients, and a number of studies have demonstrated lower rates of adjuvant therapy, and similar rates of chemotherapy toxicity (4,5). This suggests that well selected elderly patients can be effectively and safely treated similar to younger patients