Is routine malnutrition screening needed at Liverpool Cancer Therapy Centre? — ASN Events
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Is routine malnutrition screening needed at Liverpool Cancer Therapy Centre? (#240)

Christina Jandzio 1 , Ka Hi (May) Mak 2 , Katherine Bell 2 , Stephanie Notaras 2 , Marika Diamantes 2 , Steffi Khonasti 2 , Rebecca Jarman 2
  1. Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia
  2. Nutrition and Dietetics, Liverpool Hospital, Liverpool, NSW, Australia

Background

Malnutrition in oncology patients is associated with reduced quality of life, increased treatment related side effects and adverse reactions, reduced tumour response and reduced survival1 2 .  Timely identification of malnutrition and nutritional intervention is crucial to improve patient outcomes3 . Presently, routine screening for malnutrition is not undertaken at Liverpool Cancer Therapy Centre.

Aims

The primary aim was to determine the prevalence of malnutrition in patients receiving outpatient chemotherapy and/or radiotherapy. The secondary aim was to establish whether current referral practices are adequately identifying those malnourished patients.

Method

Fifty-three consenting patients (29 females) were included in this prospective one-day study. Nutritional status was assessed using a validated nutrition assessment tool, the scored Patient-Generated Subjective Global Assessment (PG- SGA)4 .

Results

The mean age was 60.8 years (± 13.6 years) and the sample was reflective of the tumour group distribution of the centre.  Twenty-six percent of patients were malnourished (PG-SGA=B or C) which included a high number of patients with head and neck, upper gastrointestinal tract and lung cancers.  Malnutrition was significantly associated with male gender (OR 4.5, 95% CI 1.2-16.9, p= 0.02) and stage IV disease (OR 11, 95% CI 2.1-57.7, p= 0.001). There was no statistically significant difference in nutritional status by age or current treatment.  Fifteen precent of patients were receiving dietetic intervention however half of the malnourished patients were not known to dietetic services.  The results are similar to those of other oncology specific outpatient malnutrition prevalence studies5 6 . 

Conclusions

The results confirm the high prevalence of malnutrition by PG-SGA assessment in patients receiving outpatient anti-cancer treatment at the Liverpool Cancer Therapy Centre and the relatively low level of referral for dietetic intervention. Implementation of routine malnutrition screening could be used to trigger dietetic referral, potentially improving patient nutritional level, enhancing overall treatment tolerance and quality of life.

  1. J. Arends, G Bodky, F Bozzetti, K Fearon, M Muscaritoli et al. 2006. ESPEN Guidelines on Enteral Nutrition: Non-surgical oncology. Clinical Nutrition 24, 245-259.
  2. M. Pressoir, S. Desne, D. Berchery, G. Rossignol et al. 2010. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. British Journal of Cancer. 102: 966-971.
  3. L. Santarpia, F. Contaldo, F. Pasanisi 2011. Nutritional screening and early treatment of malnutrition in cancer patients. Journal of Cachexia Sarcopenia Muscle. 2:27-35.
  4. J. Bauer, S. Capra, M. Ferguson 2002. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool for patients with cancer. European Journal of Clinical Nutrition. 56: 779-785.
  5. J. Read, B. Choy, P. Beale, S. Clarke 2006. An evaluation of the prevalence of malnutrition in cancer patients attending the outpatient oncology clinic. Asia-Pacific Journal of Clinical Oncology. 2: 80-86.
  6. F. Bozzetti, L. Mariani, S. Lo Vullo et al. 2012. The nutritional risk in oncology: a study of 1453 cancer outpatients. Supportive Cancer Care. 20: 1919-1928.
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