Nutritional Status and Its Determinants among Adults with Cancer Prior to the Initiation of Chemotherapy: An Ordinal Regression Analysis

The nutritional status of adults before the initiation of chemotherapy in low-income countries has been poorly explored. This study aimed to determine the prevalence of malnutrition and its associated factors before initiating chemotherapy at major cancer centers in Ethiopia. A multicenter cross-sectional study was conducted from February 13 to June 4, 2024, involving 400 adults diagnosed with solid tumors. The Patient-Generated Subjective Global Assessment (PG-SGA) was used to evaluate nutritional status. A multiple ordinal logistic regression model was used to determine associated factors. The results showed that 65% (60.2 - 69.5%) of patients were malnourished. Of these, 26% exhibited moderate malnutrition, and 39% experienced severe malnutrition. The factors that increased the odds of the highest category (severe malnutrition) were male sex (adjusted odds ratio [AOR] = 1.83), lack of regular physical activity (AOR = 1.59), presence of nutrition-impact symptoms (AOR = 33.1), gastrointestinal cancer diagnosis (AOR = 3.3), stage 4 cancer (AOR = 2.2), and preexisting comorbidities (AOR = 1.96). Conversely, a history of surgery was associated with lower odds of malnutrition (AOR = 0.46). Overall, two-thirds of adults with cancer were malnourished. Therefore, early nutritional assessment, management of nutritional impact symptoms, increased cancer awareness for early detection, and regular physical activity are recommended.