Malnutrition and the Survival of Cervical Cancer Patients: A Prospective Cohort Study Using the PG-SGA Tool

Abstract

Background

Cervical cancer is the second most common cancer among women in developing countries. Malnutrition is associated with poor prognosis and early detection of malnutrition and timely nutritional interventions can improve the outcome for cervical cancer patients. The study was aimed to assess the association between the nutritional status and survival of cervical cancer patients.

Methods

A prospective cohort study design was used. Overall 175 cervical cancer patients were followed over one year period with (median 8.5 mo, range (3.6-12).

Results

The prevalence of malnutrition determined by means of the PG-SGA was 17.7% at admission and 47.1% at the end of follow-up. According to the SGA, one in three (29.7%) patients required nutritional intervention at the end of follow-up. Patients who were malnourished (PG-SGA-B and C) had an increased risk of mortality (Hazard Ratio [HR]: 3.12, 95% CI: 1.23 − 7.86) as compared to those who were well nourished (PG-SGA-A). Patients from rural areas had an increased risk of mortality (HR: 6.99, 95% CI: 2.07 − 23.58) compared to patients from urban areas.

Conclusion

In the context of developing country setting and COVID19 outbreak, malnutrition significantly decreases cervical cancer survival. A thorough nutrition assessment using scored PG-SGA is needed.

Acknowledgments

We would like to express our sincere gratitude and special thanks to the administration offices of the hospitals for providing necessary support. Our special thanks go to the supervisor and the oncology nurses. Finally, we would like to thank all study participants for providing the necessary information.

Transparency Declaration

The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported on. The lead author affirms that no important aspects of the study have been omitted and that any discrepancies in the study (registered with the Research Ethics Committee, Department of Health Studies, University of South Africa, and the Scientific and Research Ethics Committee of Ethiopian Public Health Institute) have been explained. The reporting of this work is compliant with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (37).

Declaration of Interest Statement

The authors report no conflicts of interest.

This is part of a PhD work supported by the Ethiopian Ministry of Science and Higher Education and the University of South Africa.

Authors’ Contributions

These authors (TG, LR) contributed equally to this work.