Implementation of a Psychologist-Led Geriatric Oncology Care Model: A Retrospective Evaluation of Quality Indicator Data

Introduction: Older adults with cancer are a heterogeneous population in whom treatment decisions should be informed by functional rather than chronological age. Since 2010, the Kortrijk Cancer Centre (Belgium) has implemented a hospital-wide, psychologist-led geriatric oncology care model, in which clinical psychologists perform a two-step geriatric assessment (GA). All patients aged ≥ 70 years with a new cancer diagnosis and/or starting a new line of active treatment are routinely screened with the Geriatric 8 (G8) questionnaire, covering age, nutrition, weight loss, mobility, neuropsychological condition, BMI, medication and health status. Patients with G8 ≤ 14 proceed to a short comprehensive geriatric assessment (sCGA).

Methods: This retrospective evaluation analysed routinely collected quality indicator data on geriatric assessment implementation. Patients aged ≥ 70 years with at least two contacts at the oncology day hospital and a multidisciplinary tumour board meeting between January 2024 and May 2026 were included. Data were extracted from the electronic health record and visualised in a real-time Power BI dashboard. The primary outcome was the proportion of eligible patients receiving G8 screening, benchmarked against a predefined institutional target of 80%.

Results: A total of 891 patients were eligible for G8 screening, of whom 850 (95.4%) were screened. After accounting for documented valid exceptions (e.g. hormonal therapy only, myelodysplastic syndrome or absence of malignancy; n=34), overall screening coverage reached 99.2%. Quarterly screening rates consistently exceeded the 80% benchmark throughout the observation period. Secondary analyses revealed that, among screened patients, 468 (55.1%) were classified as vulnerable (G8 ≤ 14).

Discussion: These findings demonstrate that a psychologist-led, two-step geriatric oncology model can achieve exceptionally high and sustained implementation of GA in routine oncology care. The Kortrijk model illustrates a well-developed example of structurally embedded geriatric assessment in older adults with cancer.