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Addressing malnutrition in Victorian Cancer Services: Are we making a difference? (#131)

Kathryn Marshall 1 , Nicole Kiss 1 , Amber Kelaart 1 , Kathryn Whitfield 2 , Jenelle Loeliger 1 , Linda Nolte 1
  1. Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
  2. Victorian Government Department of Health, Melbourne, Victoria, Australia

Cancer-related malnutrition is a significant supportive care need in the cancer population, requiring timely screening, assessment and invention to improve patient outcomes. This 2014 survey repeats a 2012 study of the prevalence of malnutrition in adults with cancer across Victorian health services.

Aims: To determine the prevalence of malnutrition for in-patients and ambulatory adult patients receiving chemotherapy and/or radiotherapy.

Methods: Twenty-four Victorian hospitals participated in a prospective point prevalence study of adult cancer patients in May 2014. The Malnutrition Screening Tool (MST) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to determine the risk and presence of malnutrition, respectively.

Results: A total of 1932 patients consented to participate, representing 80% of eligible patients. Compared to the 2012 survey, there were similar patient numbers by treatment modality and tumour type, but a higher proportion of patients with metastatic disease (40% vs. 35%, p<0.001). The overall malnutrition prevalence identified reduced from 31% in 2012 to 27% in 2014. This difference reflects significant reductions in the malnutrition prevalence of patients receiving ambulatory chemotherapy (17.5% vs. 25%, p <0.0001), those with upper gastro-intestinal tract cancers (47% vs. 62%, p=0.01) and colorectal tumours (25% vs. 33%, p=0.02). No other difference in malnutrition prevalence was found by tumour types. The tumour types with the highest volume of malnourished patients continue to be haematological (29%, n=333), colorectal (25%, n=301), upper gastro-intestinal tract (47%, n=187), lung (33%, n=188) and breast (14%, n=423). The proportion of patients identified as malnourished receiving dietetic intervention remained unchanged (56% in both surveys).

Conclusions
A reduction in overall cancer malnutrition prevalence in Victorian cancer services was observed. This was most pronounced in the patient groups previously identified as most at risk. This may be a result of increased awareness, and targeted projects to address and improve cancer malnutrition in Victoria.

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