Investigation of nutritional status in Chinese patients with common cancer

Abstract

<p indent="0mm">The negative influence of malnutrition on patients with malignant tumors runs through the whole course of a disease. To the best of our knowledge, the nutritional status of cancer patients has not yet been reported in a large sample size. Therefore, this study aimed to investigate the status of malnutrition and nutritional support therapy in a large sample of patients with common malignant tumors in China. In this observational multicenter study, 80 tertiary hospitals in 22 major provinces and cities were selected using a two-stage random sampling method. A total of 47,488 hospitalized patients with 16 kinds of common malignant tumors were enrolled in this study. The nutritional status of the patients was assessed by the scored Patient-Generated Subjective Global Assessment (PG-SGA). The severity of malnutrition was identified by a quantitative assessment where 0–1 was labelled as no malnutrition and 2–3, 4–8, and ≥9 were defined as suspected/mild, moderate and severe malnutrition. The PG-SGA scores of patients with different tumor characteristics were compared by a variance analysis. The incidence rate of moderate and severe malnutrition was 58.2%, of which 32.1% and 26.1% fell under the category of moderate and severe malnutrition, 22.2% were suspected/mild and only 19.6% of the sample were not malnourished. The incidence of malnutrition varied in respect to tumor species, age, gender, tumor stage, treatment and region: The PG-SGA score of pancreatic cancer patients was the highest (9.58±5.74), and that of breast cancer patients was the lowest (3.51±3.49); The PG-SGA score of &lt;45 years old group was the lowest (4.84±4.50), and the score of ≥70 years old group was the highest (7.82±5.10); The PG-SGA scores of lung cancer (5.87 <italic>vs.</italic> 5.60, <italic>P</italic> = 0.006) and gastric cancer (8.36 <italic>vs.</italic> 7.81, <italic>P</italic>&lt;0.001) were higher in females than in males; Patients with higher TNM stage had higher PG-SGA scores. The PG-SGA score of patients with pancreatic cancer III and IV was the highest in the group, and the PG-SGA score of breast cancer patients in stage I to III was lower than 4. The PG-SGA score of the patients who received surgical treatment was the highest (6.22±4.74), while the patients who had not received any treatment had the lowest score (5.61±4.68). The PG-SGA score of central China was the lowest (4.82±4.16), and that of East China was the highest (7.31±5.53). In addition, the PG-SGA scores of patients with different types of medical insurance, education level, occupation, region and nationality were significantly varied in some tumor types. For example, farmers and those with low levels of education in primary schools and below had the worst nutritional status. A total of 68.78% of cancer patients did not receive any nutritional support, and the rate of non-nutritional support was still as high as 55.03% in the PG-SGA ≥9 group. The results of the study highlighted that the incidence of malnutrition in patients with common malignant tumors in China is high, but the rate of nutritional support is low. Malnutrition in patients with malignant tumors seems to be correlated with age, gender, tumor species, TNM stage, treatment, administrative region, medical insurance type, education level, occupation, nationality and other relevant factors. This paper calls for attention to the nutritional status and nutritional treatment of cancer patients, especially in relevance to those with upper digestive tract issues, the elderly, farmers, those with low educational levels and advanced cancer patients. Emphasis should also be placed on others with high risk of malnutrition should and the overall clinical nutritional treatment rate of cancer patients should be improved.

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