{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:08:52Z","timestamp":1783912132781,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The incidence of most cancers increases with age and cancer is a leading cause of morbidity and mortality in the older population. Older cancer patients frequently have additional co-morbidities and functional decline, which can substantially affect treatment outcomes. Major oncology societies recommend a screening for geriatric impairments in patients at risk (e.g. G8), followed by a comprehensive geriatric assessment (CGA). Nevertheless, CGA is often not established in routine care. We describe the implementation process of CGA in patients with hematological cancers at the University Hospital of Zurich. We evaluate its benefits, its perception by physicians and patients, and identify potential obstacles and solutions to allow integration into daily clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This retrospective, single-center observational study was conducted at the University Hospital of Zurich. Patients aged \u226565 years with hematological malignancies who underwent CGA within the last 5 years were included. Patients were referred for CGA based on physicians\u2019 choice. All data were extracted from electronic medical records and later analyzed. Perception of the CGA by patients and physicians was assessed by a questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>46 patients who underwent CGA between April 2019 and July 2023 were included in this study. 89.1% showed at least one impaired domain in the CGA. For 98% of patients, one or more interventions were suggested. Low G8 scores were significantly associated with detected CGA-impairments (p&amp;lt;0.05). 70% of patients found the CGA and its resulting recommendations useful and reported benefiting from the process. 75% of the physicians rated the resulting CGA report as helpful for their clinical assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data support the use of a CGA in older patients with hematological cancers based on positive feedback on its implementation, from both patients and treating physicians. Our results emphasize the need for a dedicated geriatric assessment in an older cancer population as it contributes to a more comprehensive medical evaluation and potentially improves overall care and quality of life for patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1570889","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T05:35:31Z","timestamp":1755063331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Implementing comprehensive geriatric assessment in an academic hematologic outpatient setting: experiences from medical doctors and patients"],"prefix":"10.3389","volume":"15","author":[{"given":"Steven Pierre","family":"Hiltgen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike A.","family":"Bischoff-Ferrari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gagesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kaltenborn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus G.","family":"Manz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max J.","family":"Rieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahel","family":"Schwotzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian M.","family":"Stolz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Zenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"R\u00f6sler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-019-0721-1","article-title":"Cancer as a disease of old age: changing mutational and microenvironmental landscapes","volume":"122","author":"Laconi","year":"2020","journal-title":"Br J Cancer"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.1016\/j.amepre.2013.10.029","article-title":"Age and cancer risk: a potentially modifiable relationship","volume":"46","author":"White","year":"2014","journal-title":"Am J Prev Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"277","DOI":"10.3322\/caac.20073","article-title":"Cancer statistics, 2010","volume":"60","author":"Jemal","year":"2010","journal-title":"CA Cancer J Clin"},{"key":"B4","volume-title":"Cancer stat facts: leukemia","author":"Surveillance","year":"2024"},{"key":"B5","volume-title":"Global cancer observatory: cancer tomorrow (version 1.1)","author":"Ferlay J","year":"2024"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2013.12.018","article-title":"The relevance of a geriatric assessment for elderly patients with a haematological Malignancy\u2013a systematic review","volume":"38","author":"Hamaker","year":"2014","journal-title":"Leuk Res"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-746420","article-title":"Frailty and the management of hematologic Malignancies","volume":"131","author":"Abel","year":"2018","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.10.018","article-title":"Frailty: an emerging geriatric syndrome","volume":"120","author":"Ahmed","year":"2007","journal-title":"Am J Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.3.M255","article-title":"Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care","volume":"59","author":"Fried","year":"2004","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00743","article-title":"The use and knowledge of validated geriatric assessment instruments among US community oncologists","volume":"18","author":"Gajra","year":"2022","journal-title":"JCO Oncol Pract"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.245803","article-title":"Geriatric assessment in older patients with a hematologic Malignancy: a systematic review","volume":"105","author":"Scheepers","year":"2020","journal-title":"Haematologica"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr587","article-title":"Screening older cancer patients: first evaluation of the G-8 geriatric screening tool","volume":"23","author":"Bellera","year":"2012","journal-title":"Ann Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"103657","DOI":"10.1016\/j.esmoop.2024.103657","article-title":"Adequate assessment yields appropriate care-the role of geriatric assessment and management in older adults with cancer: a position paper from the ESMO\/SIOG Cancer in the Elderly Working Group","volume":"9","author":"Loh","year":"2024","journal-title":"ESMO Open"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00933","article-title":"Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy: ASCO guideline update","volume":"41","author":"Dale","year":"2023","journal-title":"J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.04.016","article-title":"A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer","volume":"10","author":"van Walree","year":"2019","journal-title":"J Geriatr Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.12.025","article-title":"Management of prostate cancer in elderly patients: recommendations of a task force of the international society of geriatric oncology","volume":"72","author":"Droz","year":"2017","journal-title":"Eur Urol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr587","article-title":"Screening older cancer patients: first evaluation of the G-8 geriatric screening tool","volume":"23","author":"Bellera","year":"2012","journal-title":"Ann Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(23)00101-0","article-title":"G8 screening and health-care use in patients with cancer","volume":"4","author":"Bouzan","year":"2023","journal-title":"Lancet Healthy Longev"},{"key":"B19","first-page":"48","article-title":"The geriatric assessment","volume":"83","author":"Elsawy","year":"2011","journal-title":"Am Fam Physician"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds619","article-title":"Relevance of a systematic geriatric screening and assessment in older patients with cancer: results of a prospective multicentric study","volume":"24","author":"Kenis","year":"2013","journal-title":"Ann Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01367-0","article-title":"The effect of geriatric intervention in frail older patients receiving chemotherapy for colorectal cancer: a randomised trial (GERICO)","volume":"124","author":"Lund","year":"2021","journal-title":"Br J Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(22)00169-6","article-title":"Integrated Geriatric Assessment and Treatment Effectiveness (INTEGERATE) in older people with cancer starting systemic anticancer treatment in Australia: a multicentre, open-label, randomised controlled trial","volume":"3","author":"Soo","year":"2022","journal-title":"Lancet Healthy Longev"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01789-X","article-title":"Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study","volume":"398","author":"Mohile","year":"2021","journal-title":"Lancet"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e214158","DOI":"10.1001\/jamaoncol.2021.4158","article-title":"Geriatric assessment-driven intervention (GAIN) on chemotherapy-related toxic effects in older adults with cancer: A randomized clinical trial","volume":"7","author":"Li","year":"2021","journal-title":"JAMA Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.8170","article-title":"Time to stop saying geriatric assessment is too time consuming","volume":"35","author":"Hamaker","year":"2017","journal-title":"J Clin Oncol"},{"key":"B26","article-title":"Functional evaluation: the barthel index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md State Med J"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/37.3.323","article-title":"Measurement of functional activities in older adults in the community","volume":"37","author":"Pfeffer","year":"1982","journal-title":"J Gerontol"},{"key":"B28","volume-title":"Statistical Software version 23.0.2","year":"2024"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1200\/OP.23.00263","article-title":"Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy: ASCO guideline questions and answers","volume":"19","author":"Williams","year":"2023","journal-title":"JCO Oncol Pract"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.12.007","article-title":"The underreporting of phase III chemo-therapeutic clinical trial data of older patients with cancer: A systematic review","volume":"11","author":"BrintzenhofeSzoc","year":"2020","journal-title":"J Geriatr Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.8687","article-title":"Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology","volume":"36","author":"Mohile","year":"2018","journal-title":"J Clin Oncol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.6727","article-title":"Under-representation of older adults in cancer registration trials: known problem, little progress","volume":"30","author":"Scher","year":"2012","journal-title":"J Clin Oncol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.08.001","article-title":"Modifiable factors affecting older patients\u2019 quality of life and physical function during cancer treatment","volume":"10","author":"Kirkhus","year":"2019","journal-title":"J Geriatr Oncol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/s00520-023-07845-w","article-title":"Is the ECOG-PS similar to the sarcopenia status for predicting mortality in older adults with cancer","volume":"31","author":"Sousa","year":"2023","journal-title":"A prospective cohort study. Support Care Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.278802","article-title":"Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic Malignancies","volume":"107","author":"DuMontier","year":"2022","journal-title":"Haematologica"},{"key":"B36","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1001\/jamaoncol.2019.4728","article-title":"Communication with older patients with cancer using geriatric assessment: A cluster-randomized clinical trial from the national cancer institute community oncology research program","volume":"6","author":"Mohile","year":"2020","journal-title":"JAMA Oncol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1111\/bjh.15224","article-title":"Time to treatment is an independent prognostic factor in aggressive non-Hodgkin lymphomas","volume":"181","author":"Olszewski","year":"2018","journal-title":"Br J Haematol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2024.285225","article-title":"Time from diagnosis to treatment has no impact on survival in newly diagnosed acute myeloid leukemia treated with venetoclax-based regimens","volume":"109","author":"Baden","year":"2024","journal-title":"Haematologica"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1570889\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T05:35:32Z","timestamp":1755063332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1570889\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":38,"alternative-id":["10.3389\/fonc.2025.1570889"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1570889","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"article-number":"1570889"}}