A cross-sectional study examining the prevalence of cachexia and areas of unmet need in patients with cancer

Abstract

Purpose The semantics of defining cancer cachexia over the last decade has resulted in uncertainty as to the prevalence. This has further hindered the recognition and subsequent treatment of this condition. Following the consensus definition for cancer cachexia in 2011, there is now a need to establish estimates of prevalence. Therefore the primary aim of the present study was to assess the prevalence of cachexia in an unselected cancer population. A secondary aim was to assess patient-perceived need of attention to cachexia. Methods A cross-sectional study in hospital patients was undertaken. Key inclusion criteria were: age >18 years, cancer diagnosis, and no surgery the preceding 24 hours. Data on demographics, disease, performance status, symptoms, cachexia and patients’ perceived need of attention to weight loss and nutrition was registered Results Data were available on 386 of 426 eligible patients. Median age (IQR) was 65 years (56-72), 214(55%) were male and 302(78%) had a performance status of 0-1 (Eastern Cooperative Oncology Group). Prevalence of cachexia (inpatients/outpatients) was 51%/22%. Prevalence was highest in patients with gastrointestinal cancer (62%/42%) and lung cancer (83%/36%). There was no major difference in prevalence between patients with metastatic (55%/24%) and localized disease (47%/19%). 20% of inpatients and 15% of outpatients wanted more attention to weight loss and nutrition. Cachexia (p<0.001), symptoms of mood disorder (p<0.001) and male gender (p<0.01) were independently associated with increased need of attention. Conclusion Cachexia is a prevalent condition, affecting both patients with localized and metastatic cancer. Clinical attention to the condition is a sizeable unmet need.