Malnutrition Risk Among People Receiving Palliative Radiation Therapy at BC Cancer

Study Background & Rationale:

Background: People who live in rural and remote settings may be disproportionately impacted by the social determinants of health, in particular access to health services. The impact of geographical distance to a cancer treatment center on malnutrition risk is not well understood. This research project characterized and analyzed malnutrition risk in relation to distance to the nearest BC Cancer centre among people receiving palliative radiation therapy (PRT) for gastrointestinal or breast cancer.   

Methodology:
This retrospective study utilized malnutrition screening data from BC Cancer’s Early symPtom Indicators for Cancer Care (EPICC) Screening Program, implemented at the Prince George and Vancouver centres from 2019-2022.	Malnutrition Screening Tool (MST) scores ranged from 0-5, where scores of 0-1, 2-3, and 4-5 indicated low, moderate, and high malnutrition risk, respectively. Descriptive statistics were used to characterize malnutrition risk.	Patient addresses and Google Maps were used to analyze the distance between patients’ primary residence to the nearest BC Cancer center. A Kruskal-Wallis test was conducted to compare differences in total malnutrition score by regional location of EPICC participants.

Results:

• Of 802 screens from 402 cancer patients, 32% indicated moderate and 7.5% high malnutrition risk, with 68% of repeat screeners showing changes over time.
• Highest MST scores were found in patients living both very close and very far from cancer centres, though differences by distance were not statistically significant. 

Conclusion:

• Malnutrition risk changed over time for many patients, supporting the need for ongoing screening.
• Geographic distance to cancer centres was not associated with malnutrition risk, but further research is needed on how access to services may influence outcomes.