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e18571 Background: cervical cancer (CC) reveals regional and social inequalities and should be understood not only as an oncological indicator, but essentially as an indicator of social vulnerability and health care needs.CC is the second most incident and the most deadly among women from the Northeast’S Brazil and the third most incident in Brazil Although the HPV vaccine coverage and the Pap smear test are available through the Brazilian public health system, the coverage of the target population is low. objective: Verify the conditions of access/use of the health system by women with cervical cancer (CC) and their families. Methods: Cross-sectional study involving cancer patients admitted to IMIP between 2016 and 2019. The variable data were related to the sociodemographic profile, preventive examination, Human Papillomavirus (HPV) and the influence of the diagnosis of CC on the search for preventive and screening measures by women's family members. Results: Out of the 285 participants,between 9-21 years old and 101 between 25-69 years old. Of the patients studied,55,8% lives urban area. It has a higher performance of biopsies in the public sector (59,5%). The sociodemographic analysis highlights the non-white race (78,2%) and only 6,8% with complete high school. The knowledge about performing the Pap smear reached 88,9% and the disinformation about the HPV reached 44,4%.the school was the largest source of information about the HPV vaccine (30,6%). Related to the influence of cancer, 62,2% said that young family members underwent HPV vaccination and 82,2% related their diagnosis to search for preventive in family members over 25 years old. a much higher percentage than vaccination coverage and preventive exam in the study region report that the diagnosis of cancer influenced the decision to vaccinate (42%) and update the pap test (69%). about 30% of patients had never taken the pap test. the early start (15 - 19y) of the pap test was not significant for the periodic performance of the pap test. 46% reported the lack of information about the importance of the exam as a reason for not performing it and 34% reported fear. conclusion :Strengthening educational activities and offering vaccines against HPV and Pap smears in the diagnosis of a case of cervical cancer can be an opportunity to expand the coverage of preventive measures more effectively among people close to the patient and her community, which cannot be missed. The school was an important source of information about the HPV vaccine and should be directly involved in this fight.Reducing an inequality cycle.

e13628 Background: Cervical cancer (CC) is the second most incident and the most deadly among women from the Northeast’S Brazil and RECIFE-Pernambuco and the third most incident in Brazil. The occurrence of CC expresses a reality of inequality and inequity and should be understood not only as an oncological indicator, but essentially as an indicator of social vulnerability and health care needs. Its distribution occurs heterogeneously. Methods: Determine the geolocation of areas of greatest risk of occurrence of SC from the social and health determinants Considering the high incidence and mortality related to cervical cancer between 2006-2015, in the city of Recife, we used the spatialization technique to identify the most vulnerable territories for our intervention in the city of Recife. Results: 3,844 Cervical Cancer notifications AND 276 OBITUATIONS registered in the period 2006-2015 and the number of deaths in the period from 2009 to 2018, as a result, there are five areas of high influence. from spatialization, the heat zone generated by the 47 deaths that occurred in the north of the city of Recife WAS DETERMANED. Regarding the cytopathological supply, the ratio in 2018 was 0.37, being below the state average, which is 0.41. With a deficit of 45,041 screening cytopathological exams in the age group 25-64 years.the III Health Region was identified, based on the analysis of information from the State Health Secretary, which shows to be one of the areas of great social vulnerability, since 63% of the 22 municipalities that make up this health region and its population is in extreme poverty, according to IBGE (2010). Conclusions: The occurrence of deaths and new cases of cervical cancer in the city of Recife occurs geographically unequally and is associated with indicators of social vulnerability. IS IT POSSIBLE to identify a priority region to intensify public actions for prevention and early diagnosis. A challenging scenario has been found and must be actively addressed.

e23035 Background: According to the World Health Organization (WHO), the definition of "elderly" varies according to the degree of development of the country. In Low and Medium Development Countries (LMDC), a person aged 60 or older is considered elder, opposed to developed countries (65 or older). It is in LMDC that is occurring the largest relative increase in the incidence of cancer, specially those related to aging. The Comprehensive Geriatric Assessment (CGA) is still underutilized in oncological clinical practice, especially in LMDC. Objectives: To determine predictive factors for the occurrence of early death (in the first six months of surveillance) and to perform the development and temporal validation of a practical prognostic score based on the CGA to predict early death (up to 180 days) in elderly cancer patients. Methods: A prospective cohort enrolled elderly patients ≥ 60 years with a recent cancer diagnosis admitted between 2015-2017. The CGA performed at the time of admission included the following instruments: CCI; KPS; MMSE; TUG test; IPAQ; ADL; MNA; MNA-SF; GDS15; PPS and Polypharmacy. The studied outcome was early death, defined as the one that occurred within the first six months after the diagnosis. Survival analysis (Kaplan-Meier) and Cox proportional hazard regression was performed. Results: 889 patients were included in the study, performed at a referral center in cancer of a teaching hospital in Northeastern Brazil. The independent risk factors for death identified by CGA were: Mini exam of mental state (MMSE) as a continuous variable (HR 1.04 95% CI 1.00-1.07), Geriatric depression scale (GDS-15) ≥ 10 (HR 1 , 50 IC95% 1.10-2.07), Karnofsky Functional Performance Scale (KPS) < 50 (HR 1.57 IC95% 1.02-2.42), Katz Index ≤4 (HR 2.58 IC95% 1.68-3.97) and the Mininutrition assessment (MAN-SF) < 12 (HR 2.96 IC95% 2.00-4.39), with higher risk for early death amongst patients with abnormalities detected by the scales performed at admission (log rank < 0.001). Conclusions: Comprehensive geriatric assessment is an important tool to identify fragility in elderly cancer patients. Some of its scales should be incorporated into clinical practice, as they are simple and significant prognostic markers and identify patients with a higher risk of death in the first twelve months.

e23040 Background: Elderly oncology patients are not often included in studies of new therapeutic guidelines. The modified-G8 is easy to use, has satisfactory accuracy and does not require additional tools. Its value for predicting early death has not been evaluated. Objective: To evaluate accuracy of the modified G8 instrument for prediction of early death (up to 6 months) in elderly Brazilian patients (≥ 60 years). Methods: We used data from a prospective cohort with participants aged 60 years or older and a recent diagnosis of a solid neoplasm, followed in a geriatric oncology outpatient clinic between 2015 and 2017. Sociodemographic, clinical and laboratory data were obtained, along with CGA. From the primary data, we developed a modified-G8 score using 6 as the cut-off point, normal being < 6 and abnormal being ≥ 6. The primary outcome was early death (occurring within up to 6 months) considered the gold standard for the accuracy study of modified-G8 as a predictor of early death. Through bivariate and Cox multivariate analysis, the risk for early death (Hazard Ratio - HR crude and adjusted) was determined. Overall survival was estimated using the Kaplan-Meier method, and the log-Rank test was used for comparisons according to the categorization of the scores. Results: Of the 889 participants included, 537 (60%) had modified G8 scores ≥ 6 (abnormal). The overall mean score was 9.9 ± 8.4; mean age was 72,5 years (range, 60–97 years), 38% were 60 and 70 years of age. Fifty-two percent of the participants were male. The most common tumor sites were prostate (31%) and breast (16%), followed by digestive and gynecological (both with 11%). On analysis of accuracy, we found sensitivity 91.7% (95% CI 86–95.7), specificity 45.7% (95% CI 42.1–49.4), positive predictive value 24.8% (95% CI 21.2–28.6) and negative predictive value 96.6% (95% CI 94.1–98.2), area under the ROC curve 81.7% (95% CI 77.9–85.4). The crude HR for early death among those who had abnormal scores was 8.3 (95% CI 4.6–14.9) and the age-adjusted HR, tumor site and metastatic disease at diagnosis was 4.5 (95% CI 2.5–8.3) times greater and survival was lower (log-rank p 0.001). Conclusions: The modified G8 predicted early death in an elderly population (≥ 60 years) with cancer in a northeastern Brazilian institution. Satisfactory prognostic accuracy was obtained. This instrument could reduce the number of patients who would follow-up with CGA, saving time and resources, and accelerating individualized treatment.

e23036 Background: The G8, a questionnaire with 8 questions, has been specifically developed as a screening tool for vulnerability in older patients (70+) with cancer, with results suggesting 14 points as a threshold (equivalent to 90% sensitivity and 60% specificity). Its prognostic value for early death was not evaluated in Brazilian population. Methods: Cancer patients (60 years or older) with solid organ malignancies were included in a prospective cohort in a Brazilian Geriatric Oncology Clinic, between 2015 and 2017. Before the start of any oncologic therapy, a Comprehensive Geriatric Assessment (CGA) with 12 questionnaires was performed. For this study, we analyzed the G8 (Figure 1) considering items from Mini Nutritional Assessment (MNA), polypharmacy ( > 3 medications per day), self reported health status and the age of patient. G8 score was considered abnormal if ≤14, and early death (within six months of surveillance) was the gold standard for the study accuracy. Cox proportional hazard risk and Kaplan-Meier survival curves were performed. Results: 889 patients were enrolled and there were 145 (16.3 %) early deaths. Overall, 52% were male, the extremes of age were from 60 to 97 (mean 72.5 ± 0.24), and 38% were < 70 years old. The most common cancers were prostate (31.2%), digestive tract (21.9%) and breast (16.0%); 30.4% were metastatic. 470 (52,9%) from all patients had abnormal (≤ 14) G8 score; 128 (27.2%) who had abnormal G8 score died within the first 6 months, versus 17 (4.1%) with normal score (Table 1). At cut point 14, the G8 sensitivity was 88.3% (CI95% 81.9 - 93.0); specificity 54.0% (CI95% 50.4 - 57.7); positive predictive value 27.2% (CI95% 23.3 - 31.5); negative predictive value 95.9% (CI95% 93.6 - 97.5); area under ROC curve was 0.819 (Figure 2). For those older than 70, the G8 sensitivity was 91% (CI95% 83.4 - 96.1). Abnormal scores showed significant differences in survival probability (Figure 3). Conclusions: G8 score is a strong and consistent predictor of overall 6-month survival, regardless of age, metastatic status or tumor site in Brazilian older (60 or older) oncologic patients. This finding strengthens the clinical utility of this instrument in the Geriatric Oncology and may be an option to extend the practice of Geriatric Assessment in countries with medium-low economic development, even in the younger elderly population.

e22017Background: Aging is the major risk factor for cancer. Health-related Quality of Life (HRQoL) is an important aspect to be studied in the elderly population with cancer, not only as an end-po...

10049Background: Recognizing prognostic factors is important when evaluating elderly people with cancer to decide the appropriate treatment. The Oncogeriatric Index (OGI) was developed to predict e...

e17074Background: Toll-Like Receptors (TLRs) are important in oncology research due to its role in the activation of various biological factors, inflammation and its influence on tumor progression....

e17514Background: Cervical cancer is still the third most incident cancer among Brazilian women. early diagnosis and access to oncological therapy are challenging. For 135 patients treated in 2016/...

e24142Background: Elderly cancer group is a heterogeneous and growing one. In the elderly, Toll-Like Receptors(TLRs) have been described as related to the immunosenescence process, carcinogenesis a...

e22053Background: Elderly oncology population(EOP) corresponds to an increasing and heterogeneous group with high risk to infectious complications. Advances in antimicrobial therapy have not accomp...

e21533 Background: To determine if the nutritional risk according Mini Nutritional Assessment Short-Form (MNA®-SF) is an independent factor for short-term outcomes (infection, un programmed hospitalization and premature death) within the first six months after study entry. Methods:Prospective cohort study of elderly patients (≥ 60 years) with a recent diagnosis of cancer admitted to an outpatient oncology unit. At baseline sociodemographic and clinical variables were determined and comprehensive geriatric assessment (CGA) was conducted including MNA-SF. The outcomes were first Healthcare-associated Infection, un programmed hospitalization and death. Data were analyzed using multivariate Cox proportional hazards models; overall survival was estimated using the Kaplan–Meier method and survival curves were compared using the Log rank test. Results:The cohort consisted of 608 elderly patients followed for 180 days or until the censured data. Mean age was 71.9 years (range: 60‒96), 305 (50.2%) participants were at risk of malnutrition. During this period, 216 (35.5%) participants were hospitalized, 179 (29.4%) HAI and 100 (16.4%) died. After adjustment for age, site of cancer and cancer stage the multivariate regression Cox model showed that being undernourished was an independent predictor of infection (HR = 1.88, 95%CI 1.32-2.67, p < 0.001) hospitalization (HR = 1.5, 95% CI:1.10- 2.06, p = 0.012) and death (HR = 3.12, 95% CI: 1.74‒ 5.78, p < 0.001) Conclusions:Nutritional risk at admission was identified as a significant predictor of risk for premature death, infection, and need for hospitalization in elderly cancer patients. The use of MNA-SF should be incorporated into regular geriatric assessment of older patients with cancer

e21537 Background: Components of the comprehensive geriatric assessment (CGA) correlate with risk of early mortality in elderly cancer patients (ECP). However, its complexity and the time required for its administration. The aim of this study was to determine the impact of each CGA domain on overall survival(OS) and to first step for the development of a prognostic scoring system to stratify ECP. Methods: a prospective cohort study. Participants with a recent diagnosis of cancer were from eight hospitals and one cancer center in Brazil and were recruited during their first medical appointment at the outpatient oncologic clinic. A basal CGA was done before the care decision (ADL, Charlson Comorbidity Index- CCI, Karnofsky Performance status – KPS, GDS15, IPAQ, MMSE, MNA, MNA-SF, PS, PPS, Polipharmacy, QLQc30, TUG). During the follow up of six months, information about the treatments performed and early death was collected. OS was estimated using the Kaplan–Meier method, and survival curves were compared using the Log rank test for categorical variables. A multivariate Cox proportional hazards model was used to select early death risk factors. A clinical score considering the number of risk variables was created. Results: From 2015-2016, 608 ECP, mean age 71.9 (SD ±7.4; range 60-96), 50.7% male, were enrolled. 100 (16.4%) ECP died in less than six months of follow-up. In our multivariate model, controlled by age, site of cancer and cancer stage, the remaining significant risk factors were malnutrition/nonutrition determined by MNA (HR 3.3, 95%CI 1.81-5.99, p < 0.001), KPS < 50% (HR 2.44, CI 1.56-3.81, p < 0.001) and CCI > 2 (HR 1.6, CI 1.09-2.52, p = 0.018). The risk for early death according to the number of risk variables: three (HR 12.99, CI 5.69-29.60, p < 0.001), two (HR 5.65, CI 2.61-12.24, p < 0.001) or one (HR 2.7, CI 1.28-5.87, p = 0.009). Conclusions: a practical clinical score using three instruments of the CGA (MNA, KPS and CCI) can predict independent the risk for an early death in ECP. The development of a practical system for risk scoring, incorporating few clinical prognostic factors, helps to stratify patients into risk groups and to plan a personalized care.

e21534 Background:With the aging of the population, cancer in the elderly people is becoming an increasingly common and complex health problem, particularly in low-middle-income countries, where physical inactivity and obesity have also been challenging and correlated with cancer and aging. The aim of this study is to determine whether the baseline physical inactivity per International Physical Activity Questionnaire(IPAQ) is an independent factor of premature death in the first six months.Methods: prospective cohort study of elderly patients (≥ 60 years). Participants with a recent diagnosis of cancer were from eight community hospitals and one cancer center in Northeast Brazil and were recruited during their first medical appointment at the outpatient oncologic clinic. Sociodemographic and clinical variables were determined and baseline comprehensive geriatric assessment (CGA) was conducted including IPAQ and Time Up and Go test. Data were analyzed using multivariate Cox proportional hazards models, overall survival was estimated using the Kaplan–Meier method and survival curves were compared using the Log rank test. Results:From 2015-2016, 608 patients, mean age 71.9 (SD ±7.4; range 60-96), 50.7% male, were enrolled. Main diagnoses were prostate cancer (29.1%), digestive system cancer (25.5%) and breast cancer (16.0%). 40.3% were considered obese/overweight (BMI ≥ 27). 42.1% were considered physically inactive per IPAQ. The mean of the Time Up and Go test on the physically inactive group by IPAQ was of 13.11s (SD ± 6.5), and of 22.72s (SD± 16.7) on the physically active one. After adjustment for age, site of cancer and cancer stage, the multivariate regression Cox model showed that being physically inactive is an independent predictor for early death (HR = 2.35, 95% CI: 1.50‒ 3.66, p < 0.001).Conclusions:Physical inactivity at admission was identified as a significant predictor of risk for premature death in elderly cancer patients. The evaluation of the physical activity should be incorporated into regular geriatric assessment of elderly cancer patients.

e16612Background: Cancers are increasing with aging and thus the number of elderly cancer patient is expected to increase significantly in years to come. The aims were to evaluate the cellular immune profiling associated with prostate cancer in elderly patients. Methods: We prospectively enrolled patients, who were treated and followed-up in the department geriatric clinicaloncology. Between 2015 and 2016, a prospective cohort study in 346 elderly incident cancer patients ( ≥ 60 years) , at the time of enrollment, assessed and collected socio-demographic and clinical variables and collected peripheral blood analysis in Experimental translational exploratory study. using PBMC were stained with following antibodies: anti-CD4, anti-CD8, anti-CD28, anti-CD20, anti-CD16, anti-CD56 and analyzed by four-color flow cytometry on a FACS Verse BD Bioscience. We analyzed the immune profiling of elderly patients with prostate cancer and non-cancer ( > 65). Results: We enrolled 38 patients with prostate cancer and the ...

10046Background: the elderly cancer is a heterogeneous and growing group. In the elderly, the genes of toll-like receptors (TRL) has been described as related to immunosenescence process, carcinoge...

e21529Background: Health-related quality of life (QoL) is a major concern for older patients with cancer. Methods: Between 2015 and 2016, a prospective cohort study in 346 elderly incident cancer p...