Abstract B061: Survival and multidisciplinary care outcomes following implementation of the practical geriatric assessment in a diverse gastrointestinal cancer population
Abstract
Older adults bear the highest burden of cancer yet remain underrepresented in oncology research. Hispanic patients face additional cultural, linguistic and systemic barriers that compound disparities. The practical geriatric assessment (PGA) identifies older adults with cancer who may benefit from targeted interventions, but its impact on outcomes in vulnerable populations is not well characterized. Between January 2024 and June 2026, patients ≥ 70 years were screened with the modified PGA (mPGA) in a gastrointestinal oncology clinic at an urban academic cancer center. The mPGA incorporated the standard PGA plus an additional section addressing structural barriers (e.g., transportation, housing). Assessments were conducted in patients’ primary language using bilingual staff or video/phone interpreters. Patients identified as high-risk with positive mPGA screens were discussed in Virtual Interdisciplinary Geriatric Oncology Review (VIGOR) to identify multidisciplinary interventions. The primary endpoint was 1-year survival from mPGA screening; patients less than one year out from screening were excluded. Seventy-two patients were screened (mean age 77; 56% male). The cohort was diverse: 40% Hispanic, 29% as non-Hispanic White, 17% Asian, and 7% non-Hispanic Other; 24% primarily Spanish speaking. The most prevalent cancers were hepatocellular carcinoma (28%), pancreatic cancer (26%), colorectal cancer (18%), and cholangiocarcinoma (11%). 97% of patients had at least one positive mPGA screen, with the most commonly impaired domains being physical performance (78%), comorbid conditions (82%), and social support (58%). Physical performance (p<0.01), nutrition (p=0.02), comorbid conditions (p<0.01), and total number of positive screens (p<0.01) were significantly associated with lower 1-year survival even after adjustment for age and sex and were more strongly associated with survival than ECOG performance status. 25 high-risk patients were discussed in VIGOR, generating 73 new referrals, including 18 to physical/occupational therapy (PT/OT), 13 to social work, 10 to palliative care, and 10 to nutrition. Patients discussed in VIGOR were significantly more likely to be followed by palliative care (p<0.05). Among patients screening positive for impairment in physical performance and nutrition, those discussed in VIGOR were more likely to be established with PT/OT (p<0.001) and nutrition (p<0.05). In subgroup analysis of 29 Hispanic patients, greater impairment in the physical performance domain was associated with higher social support needs (p=0.04), a finding not observed in the overall cohort. The mPGA identified a high burden of geriatric syndromes in a diverse older adult GI oncology population. Key mPGA domains outperformed ECOG status in predicting 1-year survival. Structured multidisciplinary review through VIGOR translated screening results into actionable referrals, supporting integration of geriatric assessment and interdisciplinary review into routine oncologic care for vulnerable populations. Kirsten V. Nguyen, Kevin Chang, Mary Aalto, Monica Zell, Alexis Kogan, Lydia In, Gabriel Wang, Rachel Lander-Canseco, Gerardo Gorospe, Grace Kim, Mario Lopez, Rabia Rehman, Megan Seifert, Kristyn Carolino, David Bateshansky, Stacey Morikawa, Hirsch Matani, Carnie Lewis, David Maguellal, Sandra Algaze. Survival and multidisciplinary care outcomes following implementation of the practical geriatric assessment in a diverse gastrointestinal cancer population [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B061.