Background: Geriatric Assessment (GA) can help oncologists determine fitness of their older patients for cancer therapy. Our objective was to identify gaps that exist in the care of older adults with gastroesophageal cancer (GEC). Methods: Patients age 65 or older with any stage of GEC were consented and completed a self-administered GA. The patient’s provider completed a baseline assessment (PA) and abnormalities detected by both assessments were centrally reviewed and compared. Geriatric domains assessed include functional status, nutrition, comorbidities, psychological distress, cognition, social support, chemotherapy toxicity risk, and financial toxicity. Any abnormalities found within an evaluated domain were considered in the analysis. Providers reviewed patient GA alongside indicated interventions and identified those they would implement. We compared the proportions detected/not detected by PA vs GA using McNemar’s test for paired data, and we measured agreement using Kappa statistics. This is an interim report of an ongoing trial with total accrual goal of 100 older adults with GEC. Results: 33 patients were enrolled at the time of the interim analysis, majority were male (22, 67%), median age 74 (65-91), with stage III (9, 50%) disease treated with combination chemotherapy (12, 36%). Cancer site was distributed between gastric (45%), esophageal (36%), GEJ (18%). 90% of patients had ECOG status 0 or 1. GA detected 164 abnormalities in geriatric domains, mean 5 per patient, and PA detected 104 abnormalities, mean 3 per patient (see Table). Significant difference in abnormality identification between GA and PA were seen in domains of nutrition, chemotherapy toxicity risk, financial toxicity and psychological distress. 37% of patients had abnormal TUG score and those patients were more likely to have other geriatric abnormalities detected by GA (6.2 vs 4.4). Providers for 28 patients (85%) indicated they would make at least one change, with the majority being referral to social work. Conclusions: Among older adults with gastroesophageal cancer, GA identifies more abnormalities as compared to routine provider’s assessment in most cases leading to important clinical interventions.