Aims: Providing nutrition care for patients with head and neck (HN) and oesophageal (OE) cancers is complex and system level nutrition processes in cancer care centres can influence the delivery of nutrition care in these high-risk patients. This study aims to describe current nutrition care processes in place for these patients across several international cancer care settings.
Methods: In a multi-centre prospective audit, adult patients with curative HN or OE cancer were enrolled from several international cancer care settings. Details on the settings and existing processes related to nutrition screening and assessment are presented. Descriptive analyses using means, standard deviation and percentages were used.
Results: 145 patients (95 HN and 50 OE) were enrolled from 11 sites in Canada, Netherlands, Italy, Australia and United States. Nutrition screening is routinely completed in all centres by the dietitian or nurse. Seven sites (64%) use a validated screening tool (SNAQ, MST or Patient Generated Subjective Global Assessment [PG-SGA]), 4 centres use % weight loss, BMI, food history or swallowing problems. Nutrition assessment is routine practice in all centres, most commonly using height, weight, BMI & SGA followed by PG-SGA. Energy and protein needs are being determined by weight-based formulas followed by predictive equations while indirect calorimetry is used less frequently. Inflammatory markers are commonly assessed. Functional status is assessed in only 5/11 (55%) of centres.
Conclusion: Although current nutrition care processes across international cancer care settings suggest there is support in place for adequate nutrition screening and assessment in HN and OE cancer patients, there is a need to examine if these processes translate into improved delivery of nutrition in these patients. The INFORM audit (ClinicalTrials.gov ID NCT02829489) will collect data on patient level outcomes and study their association with these reported nutrition processes.