Is Nutritional Screening of Patients with Lung Cancer Optimal? An Expert Opinion Survey of French Physicians and Surgeons

Abstract

Objectives: To assess how physicians and surgeons carried out malnutrition screening and follow-up for patients with lung cancer.

Materials and methods: We carried out an expert opinion survey in France using an anonymous self-administered online questionnaire.

Results: In 2017, 206 practitioners responded, of which 60.7% were pulmonologists, 17.4% thoracic surgeons, 11.2% oncologists, and 10.7% radiotherapists. At initial diagnosis, 79.3% of practitioners recorded patients’ percentage of weight loss. During follow-up examinations, 67.5% recorded this data for patients at risk of malnutrition and 70.4 % for malnourished patients. Food intake was evaluated by 21.7% of practitioners at initial diagnosis. Surgeons assessed percentage of weight loss and food intake significantly less often than pulmonologists did, they were less likely to request serum albumin tests and waited for a greater percentage of weight loss before referring patients to a nutrition professional. All practitioners were well aware of the prevalence of malnutrition among lung cancer patients and its consequences. The main factors preventing optimal nutritional assessment reported by practitioners were a lack of time and limited specialized knowledge.

Conclusion: Nutritional assessment remained suboptimal, especially for surgical patients. The importance granted to malnutrition needs to be increased for patients with lung cancer, especially in surgical departments.

Highlights

• Physicians and thoracic surgeons are well aware of the prevalence and consequences in lung cancer patients.

• Thoracic surgeons seemed to be less sensitized to malnutrition screening than pulmonologists.

• Lack of time and limited specialized knowledge were reported as the main factors preventing optimal nutritional assessment.

Keywords:

• Lung cancer
• Malnutrition
• Nutritional assessment
• Nutritional screening
• Weight loss

Acknowledgements

The proofreading of this article was supported by the Bibliothèque Scientifique de l’Internat de Lyon and the Hospices Civils de Lyon.

Disclosure Statement

The authors have no competing interests to declare.

Author Contributions

Pauline Corbaux; Center Hospitalier Lyon Sud, Medical Oncology:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

2. drafting the article or revising it critically for important intellectual content;

Clara Fontaine-Delaruelle; Center Hospitalier Lyon Sud, Respiratory medecine:

• 2. drafting the article or revising it critically for important intellectual content

Pierre-Jean Souquet; Center Hospitalier Lyon Sud, Respiratory medecine:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

Sébastien Couraud; Center Hospitalier Lyon Sud, Respiratory medecine:

• 3. drafting the article or revising it critically for important intellectual content

Hugues Morel; Center Hospitalier Régional d’Orléans, 14 avenue de l'hôpital, 45067 Orléans, France:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

François Tronc; Hôpital Louis Pradel, University of Lyon 1, 59 Boulevard PINEL, 69500 Bron, Thoracic surgery:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

Elife Eker; Center Hospitalier Lyon Sud, Radiotherapy:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

Julien Peron; Center Hospitalier Lyon Sud, Medical Oncology; Center Hospitalier Lyon Sud, Department of Biostatistics:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data

2. drafting the article or revising it critically for important intellectual content

Bruno Raynard; Institut Gustave Roussy, University of Paris Sud, 114 rue Edouard Vaillant, 94800 Villejuif, France, Transversal Unit of Dietetics and Nutrition:

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data;

2. drafting the article or revising it critically for important intellectual content;

3. final approval of the version to be published.