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Prevalence of Malnutrition and Current Use of Nutrition Support in Patients With Cancer
Authors:Xavier Hébuterne MD  PhD  Etienne Lemarié MD  Mauricette Michallet MD  PhD  Claude Beauvillain de Montreuil MD  Stéphane Michel Schneider MD  PhD  François Goldwasser MD  PhD
Affiliation:1. Gastroenterology and Clinical Nutrition, Nice Teaching Hospital (CHU), University of Nice Sophia‐Antipolis, Nice;2. Pneumology, Tours CHU, Tours, France;3. Haematology, Lyon CHU, Lyon, France;4. ENT, Nantes CHU, Nantes, France;5. Medical Oncology, H?pital Cochin, Paris, France
Abstract:Background and Aims: The aim of this study was to evaluate on 1 day the prevalence of malnutrition in different types of cancer and the use of nutrition support in patients with cancer. Methods: A 1‐day prevalence survey was carried out in 154 French hospital wards. Malnutrition was defined as a body mass index (BMI) <18.5 in patients <75 years old or <21 in patients ≥75 years old and/or body weight loss >10% since disease onset. Oral food intake was measured using a visual analog scale. Results: Nutrition status was collected for 1903 patients (1109 men and 794 women, 59.3 ± 13.2 years). Cancer was local in 25%, regional in 31%, and metastatic in 44% of patients. Performance status was 0 or 1 in 49.8%, 2 in 23.7%, 3 or 4 in 19.6% and not available in 6.5% of patients. Overall, 39% of patients were malnourished. The prevalence of malnutrition by disease site was as follows: head and neck, 48.9%; leukemia/lymphoma, 34.0%; lung, 45.3%; colon/rectum, 39.3%; esophagus and/or stomach, 60.2%; pancreas, 66.7%; breast, 20.5%; ovaries/uterus, 44.8%; and prostate, 13.9%. Regional cancer (odds ratio, 1.96; 95% confidence interval, 1.42–2.70), metastatic cancer (2.97; 2.14–4.12), previous chemotherapy (1.41; 1.05–1.89), and previous radiotherapy (1.53; 1.21–1.92) were associated with malnutrition. Only 28.4% of non‐malnourished patients and 57.6% of malnourished patients received nutrition support. In all, 55% of patients stated that they were eating less than before the cancer, while 41.4% of patients stated that they had received nutrition counseling. Conclusions: The prevalence of malnutrition is high in patients with cancer, and systematic screening for and treatment of malnutrition is necessary.
Keywords:cancer  malnutrition  screening  oral supplements  enteral nutrition  parenteral nutrition
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