Older adults account for the majority of new cancer diagnoses worldwide, but geriatric assessment (GA) — a proven tool for reducing treatment toxicity and improving quality of life — is still rarely used in routine oncology practice. Time pressures, specialist shortages, and resource gaps, particularly outside academic centers and in low- and middle-income countries, have kept uptake frustratingly low.

The 2025 ASCO Global Guideline on Geriatric Assessment aims to change that. Rather than demanding maximal resources, it stratifies recommendations into Basic, Limited, and Enhanced levels, so any oncology team can identify patient vulnerabilities and act on them with what's locally available. The Practical Geriatric Assessment (PGA) — 85% patient-reported, available in multiple languages, and completable in 10–15 minutes — is a centerpiece of this approach and can be done in waiting rooms, via patient portals, or by phone.

Telehealth is emerging as a key equalizer. A fully remote GA program in Brazil showed 92% adherence and meaningful improvements in quality of life, mood, and daily functioning. Ongoing trials across the U.S., Canada, and France are testing hybrid and fully remote models in diverse settings.

Key Takeaways:

• Screen all patients aged 65+ starting systemic therapy using the Geriatric 8 tool
• Use the ASCO PGA to assess vulnerabilities and link findings to resource-matched actions
• Leverage telehealth referrals when in-person services are limited
• Document GA findings and care plan changes to support continuity and quality metrics

Why it matters: Embedding GA into routine oncology care — even in resource-limited settings — can meaningfully reduce treatment harm and improve outcomes for older cancer patients. Telehealth makes this scalable and equitable, not just a privilege of well-resourced centers.