Low referral uptake, not patient adherence, limits implementation of early nutritional screening in head and neck and upper gastrointestinal cancers.

Authors

Irene Azzali, Debora Guerra, Monia Suzzi, Alessandro Passardi, Sebastiano Calpona, Ilario Giovanni Rapposelli, Margherita Muratore, Francesco De Rosa, Elisabetta Parisi, Roberta Volpi, Patrizia Serra

Published in

Frontiers in nutrition. Volume 13. Pages 1817590. Epub Aug 03, 2026.

Abstract

Malnutrition is highly prevalent in patients with head and neck and upper gastrointestinal cancers and is associated with poorer clinical outcomes. Despite guideline recommendations, early nutritional screening remains inconsistently implemented in routine oncology care.
This single-center prospective feasibility study evaluated the implementation of an early nutritional screening and intervention pathway in newly diagnosed oncology patients with head and neck and upper gatrointestinal cancers. Eligible patients were enrolled within 7 days of their first oncology consultation and entered a structured nutritional pathway including baseline (T0), one-month (T1), and two-month (T2) assessments. Nutritional evaluation included MUST screening, anthropometric measures, bioelectrical impedance analysis, handgrip strength, biochemical parameters, and patient-reported outcomes (ESAS and FACT-G). Feasibility endpoints included referral, enrolment, and adherence rates.
Among 550 eligible patients, 77 were enrolled (14%). Once enrolled, adherence to the pathway was high (91%). At baseline, 47% of patients were classified as at high nutritional risk. Serum biochemical markers, available in a subset of patients, were consistent with mild nutritional alterations. During follow-up, body weight, handgrip strenght, biochemical and bioelectrical impedance parameters, and overall quality of life remained stable. Significant improvements were observed in selected symptoms, including fatigue, nausea, and well-being/malaise.
Early nutritional screening is feasible and highly acceptable once implemented. However, implementation at the population level is limited by low and non-systematic referral rates, highlighting a critical gap in routine oncology care.

PMID:
42609223
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.