Digital health interventions for the perioperative care of older cancer patients: A global health perspective

Background: Older adults experience the highest cancer burden and are at increased risk for postoperative complications, highlighting the need for improved perioperative care. Digital health interventions may address challenges, such as mobility and care coordination, yet their role in geriatric oncologic surgery is understudied. Objective: To synthesize evidence on digital perioperative interventions for older cancer patients, evaluate clinical and system-level outcomes, and identify considerations for equitable global implementation. Methods: A narrative review of EMBASE, Web of Science, MEDLINE, and CINAHL (to December 30, 2024), supplemented by Google and citation searches, included studies on digital perioperative interventions in cancer patients aged ≥65. Data on study design, population, intervention type, outcomes, implementation facilitators/barriers, and global relevance were extracted. Results: Eight studies (2018–2023), all from high-income countries (US, Netherlands, Australia, Taiwan), met inclusion. Interventions included telemedicine (n=3), mobile or smart device-enabled symptom tracking (n=7), and wearable biometric monitoring (n=7). Reported benefits included improved physical activity, functional recovery, and complication detection. High adherence and acceptance were noted among all studies that measured them. However, systemic barriers were indicated, including limited internet access, device management issues, and digital literacy gaps. No studies examined cost-effectiveness, feasibility in LMICs, or cultural adaptability. Conclusions: Digital interventions may improve perioperative outcomes in older cancer patients, but current evidence is geographically limited and overlooks equity and contextual fit. Future research should apply implementation science to assess cost, cultural relevance, and system integration, especially in LMICs, to inform scalable, equitable models in global oncologic surgery.