Nutritional Risk and Unmet Nutritional Need in Ambulatory Patients Undergoing Systemic Anti-Cancer Therapies.
8 affiliations
- 1Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.
- 2Western General Hospital, Edinburgh, UK.
- 3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
- 4Clinical Psychology, Health in Social Science, University of Edinburgh, Edinburgh, UK.
- 5Marie Curie Hospice, Edinburgh, UK.
- 6Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
- 7Department of Oncology, European Palliative Care Research Centre (PRC), Radium Hospital, Oslo University Hospital, Oslo, Norway.
- 8St Columba's Hospice Care, Edinburgh, UK.
Abstract
Background and aims
Malnutrition is highly prevalent among cancer patients receiving systemic anti-cancer therapy (SACT) and is associated with poor treatment tolerance, reduced quality of life, and increased mortality. Despite recommendations, nutritional screening in the outpatient setting is inconsistently implemented and the prognostic significance of nutritional risk identified using a validated screening tool is still unclear. This study aimed to determine the prevalence of nutritional risk among patients receiving SACT, whether their nutritional needs were being met with dietetic input, and to examine associations with clinical outcomes, including treatment toxicity, dose reduction, hospital admission, and overall survival.Methods
In this prospective observational study, adult outpatients receiving SACT were invited to complete the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), a nutritional screening tool. Nutritional risk using PG-SGA SF scores was assessed in relation to treatment toxicity, dose reduction, and hospital admission using multivariable regression models and survival was evaluated using Cox proportional hazards models, both adjusted for age, sex, metastatic disease, and performance status.Results
Of 169 participants, 24.9% were at nutritional risk, PG-SGA SF score 4-8, and 10.7% at high risk ≥ 9, yet only 5.3% were in receipt of dietetic care. Higher PG-SGA SF scores were independently associated with increased treatment toxicity (OR: 1.2, 95% CI: 1.1-1.3, p = 0.003) and SACT dose reductions (OR: 1.2, 95% CI: 1.0-1.3, p = 0.040). Nutritional risk was not significantly associated with 30-day hospital admissions but was independently associated with overall survival (HR: 1.1, 95% CI: 1.0-1.2, p = 0.004).Conclusions
Nutritional risk identified using the PG-SGA SF independently predicted treatment toxicity, dose reduction, and survival in those receiving SACT. Despite over one-third of those meeting the criteria for dietetic intervention, only 5.3% were receiving dietetic care, indicating a substantial gap between dietetic need and provision. These results support implementation of routine screening, referral pathways, and a dedicated dietetic service integrated into oncology outpatient services.
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BibTeX
@article{mcluskie2026nutritional,
title = {{Nutritional Risk and Unmet Nutritional Need in Ambulatory Patients Undergoing Systemic Anti-Cancer Therapies.}},
author = {Amy McLuskie and Karen Angel and Matthew Maddocks and Anne Finucane and Marie Fallon and Barry J A Laird and Michael S Yule},
journal = {Journal of human nutrition and dietetics : the official journal of the British Dietetic Association},
year = {2026},
month = oct,
doi = {10.1111/jhn.70359},
url = {https://europepmc.org/article/MED/42876050},
note = {CC BY},
}
RIS
TY - JOUR
TI - Nutritional Risk and Unmet Nutritional Need in Ambulatory Patients Undergoing Systemic Anti-Cancer Therapies.
AU - Amy McLuskie
AU - Karen Angel
AU - Matthew Maddocks
AU - Anne Finucane
AU - Marie Fallon
AU - Barry J A Laird
AU - Michael S Yule
PY - 2026
DA - 2026/10/01
JO - Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
DO - 10.1111/jhn.70359
UR - https://europepmc.org/article/MED/42876050
AB - Background and aims Malnutrition is highly prevalent among cancer patients receiving systemic anti-cancer therapy (SACT) and is associated with poor treatment tolerance, reduced quality of life, and increased mortality. Despite recommendations, nutritional screening in the outpatient setting is inconsistently implemented and the prognostic significance of nutritional risk identified using a validated screening tool is still unclear. This study aimed to determine the prevalence of nutritional risk among patients receiving SACT, whether their nutritional needs were being met with dietetic input, and to examine associations with clinical outcomes, including treatment toxicity, dose reduction, hospital admission, and overall survival.Methods In this prospective observational study, adult outpatients receiving SACT were invited to complete the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), a nutritional screening tool. Nutritional risk using PG-SGA SF scores was assessed in relation to treatment toxicity, dose reduction, and hospital admission using multivariable regression models and survival was evaluated using Cox proportional hazards models, both adjusted for age, sex, metastatic disease, and performance status.Results Of 169 participants, 24.9% were at nutritional risk, PG-SGA SF score 4-8, and 10.7% at high risk ≥ 9, yet only 5.3% were in receipt of dietetic care. Higher PG-SGA SF scores were independently associated with increased treatment toxicity (OR: 1.2, 95% CI: 1.1-1.3, p = 0.003) and SACT dose reductions (OR: 1.2, 95% CI: 1.0-1.3, p = 0.040). Nutritional risk was not significantly associated with 30-day hospital admissions but was independently associated with overall survival (HR: 1.1, 95% CI: 1.0-1.2, p = 0.004).Conclusions Nutritional risk identified using the PG-SGA SF independently predicted treatment toxicity, dose reduction, and survival in those receiving SACT. Despite over one-third of those meeting the criteria for dietetic intervention, only 5.3% were receiving dietetic care, indicating a substantial gap between dietetic need and provision. These results support implementation of routine screening, referral pathways, and a dedicated dietetic service integrated into oncology outpatient services.
SN - 0952-3871
SN - 1365-277X
ER -