ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020
Late referral of cancer patients with malnutrition to dietitians: a prospective study of clinical practice.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Omega-3 Supplementation and Nutritional Status in Patients with Pancreatic Neoplasms: A Systematic Review.Nutrients · 2024Pooled it
- Experiences of cancer patients in receiving dietary advice from healthcare professionals and of healthcare professionals in providing this advice-a systematic review.Journal of cancer survivorship : research and practice · 2024Pooled it
- The roles of the dietitian in an 18-week telephone and mobile application nutrition intervention for upper gastrointestinal cancer: a qualitative analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Trial
- Trial
- Usefulness of Smartphone Apps for Improving Nutritional Status of Pancreatic Cancer Patients: Randomized Controlled Trial.JMIR mHealth and uHealth · 2021Trial
- Nutritional Risk and Unmet Nutritional Need in Ambulatory Patients Undergoing Systemic Anti-Cancer Therapies.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026Observational
- Symptom-Heavy Nutritional Insecurity in Older Adults Initiating Chemotherapy.Healthcare (Basel, Switzerland) · 2026Article
- Barriers to timely nutrition support in patients with cancer: A scoping review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- Article
- Impact of COVID-19 on early identification of protein-energy malnutrition in the cancer care setting: a repeated cross-sectional survey of cancer care professionals.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- A patient-mediated implementation strategy to improve nutrition care delivery for esophageal and gastric cancer: a study protocol for a pilot randomized controlled trial.Journal of health, population, and nutrition · 2025Article
- Treatment barriers among patients with cancer cachexia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Feasibility of using Simple Diet Self-Assessment Tool (SDSAT) to explore patterns of dietary intake for patients undergoing chemotherapy.Nutrition journal · 2025Article
- Malnutrition and Nutrition Impact Symptoms in Kuwaiti Colorectal Cancer Patients: Validation of PG-SGA Short Form.Nutrients · 2025Article
- Malnourished, gastrointestinal cancer patients undergoing surgery: burden of nutritional risk, use of oral nutritional supplements, and impact on health outcomes.Asia Pacific journal of clinical nutrition · 2025Article
- Article
- Documentation of anthropometrics in people with cancer: a cross-site collaboration audit in four hospital settings in the UK.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Adopting a systems-thinking approach to optimise dietary and exercise referral practices for cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Prevalence of Undernutrition Among Children and Adolescents with Cancer Living in Sub-Saharan African Countries: A Systematic Review and Meta-analysis.Global pediatric health · 2024Review
- Nutrition care is an integral part of patient-centred medical care: a European consensus.Medical oncology (Northwood, London, England) · 2023Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMalnutrition (MN) in cancer is common but underdiagnosed. Dietitian referrals may not occur until MN is established. We investigated cancer patient characteristics (demographics, nutritional status, and nutrition barriers) on referral to oncology dietitians. We also examined referral practices and prevalence of missed referral opportunities.
methodsThis was a naturalistic multi-site study of clinical practice. Data from consecutive referrals were collected in inpatient and outpatient settings. Demographics, nutritional status (weight, body mass index (BMI), weight loss in the preceding 3-6 months, oral intake, nutrition barriers), referral reasons, and use of screening were recorded. Missed opportunities for earlier referral were also noted.
resultsTwo hundred patients were included (60% male, 51% inpatients). Half had gastrointestinal and hepatobiliary cancers. The majority were on antitumor treatment. Two-thirds had lost ≥ 5% body weight. Forty percent were overweight or obese. Seventy percent had ≥ 2 nutritional barriers. Most common nutrition barriers were anorexia, nausea, and early satiety. Greater weight loss and lower food intake were associated with ≥ 2 barriers. Weight loss was the most common referral reason. Screening was used in 35%. Referrals should have occurred sooner in nearly half (45%, n = 89).
conclusionsCancer patients were referred late to a dietitian, with multiple nutritional barriers. Most referrals were for established weight loss (WL). WL may be masked by pre-existing obesity. Almost half had missed earlier referral opportunities; screening was infrequent. Over one-quarter should have been re-referred sooner. There is a clear need for clinician education. Future research should investigate the optimal timing of dietitian referral and the best nutrition screening tools for use in cancer.
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