Nutritional and psychosocial status of colorectal cancer patients referred to an outpatient oncology clinic.

purposeMalnutrition and psychological distress are associated with poorer outcomes following treatment for colorectal cancer. Screening for issues such as malnutrition, depression, and anxiety is being adopted in some oncology settings, but its effectiveness or the relationship between these risk factors in this population are not well understood.

methodsA retrospective chart review was conducted of 836 health assessment forms provided to colorectal cancer patients referred to an outpatient oncology clinic. Nutritional (Patient-Generated Subjective Global Assessment) and psychological (Psychosocial Screen for Cancer) screening tools were included in the form. Demographic and screening tool information was obtained from completed forms. The prevalence of nutritional risk, depression, and anxiety were determined based on screening tool scores and clinical cutoffs. An ordinal regression model was fitted to determine which demographic and psychosocial factors best predicted nutritional risk.

resultsOnly 252 (30%) of the forms were completed enough for inclusion in analysis. The prevalence of nutritional risk, anxiety, and depression were determined to be 29%, 10%, and 7%, respectively. A regression model containing the variables depression, anxiety, gender, health coverage, and marital status was found to best explain the nutritional score. Depression was the most significant predictor, with odds of increased nutritional risk being 5.6 times greater for depressed individuals (P = 0.0005).

conclusionsThe use of nutritional and psychosocial screening tools is warranted and needs to be emphasized more in oncology settings. There appears to be a relationship between psychosocial issues and increased nutritional risk which should be taken into account when considering cancer care interventions.