DEVELOPMENT OF A NUTRITIONAL SCREENING PROGRAM TO IDENTIFY CANCER PATIENTS AT RISK OF MALNUTRITION AND EXPEDITE TREATMENT AND CAREFUL FOLLOW-UP

Introduction: Malnutrition is a major health complication among patients with cancer. It is well-known that cancer-associated malnutrition can impact an individual’s treatment tolerance, length of hospital stays, rates of clinical and surgical complications, morbidity, and mortality. Objective: This study sought to determine the impact of an initial nutrition assessment and appropriate intervention on nutritional status during the over the course of treatment. Methods: This longitudinal study assessed treatment-naive patients in a private cancer center, located in the capital of Brazil, from August 2019 to April 2021. Patients were assessed for nutritional status, using the scored Patient-Generated Subjective Global Assessment (PG-SGA), before treatment initiation (T0) and three months later (T1). Higher scores suggest greater risk of poor nutritional status, with a score of 4-8 warranting some form of nutritional intervention (education, oral nutrition) and scores of 9+ suggesting a critical need for nutritional intervention (oral and enteral nutrition). Based on these empirically based cut-offs, appropriate interventions were implemented. General linear modeling was utilized to predict levels and changes in nutritional risk and assess the main effect of intervention. Results: A total of 47 consecutive treatment-naive patients were assessed. The majority of patients were female (53%) and with a median age of 65 years (range: 22 – 85 years). Patients were primarily diagnosed with gastrointestinal cancer (85%) and possessed advanced disease (III-IV; 62%). Nearly three quarters (72%) of patients possessed moderate to severe nutritional risk before treatment initiation. Interventions proposed as follows: education (38%), oral nutrition (58%) and enteral nutrition (4%). Notably, mean PG-SGA score significantly decreased between T0 and T1 (6.45 to 4.46, respectively; P=0.001), with all three modes of support associated with a significant decrease in scores. Conclusion: Early nutritional assessment is critical in the identification of patients who are at-risk of poor nutritional status. This preliminary study suggests that initial screening and appropriate intervention was associated with an increase in patients’ nutritional status during chemotherapy treatment. Further research is needed to explore the impact of different forms of intervention, and whether such support is associate with broader disease outcomes.