Australian cancer clinicians' awareness, understanding and perceptions regarding cancer-related malnutrition and sarcopenia

Background : Cancer‐related malnutrition and sarcopenia (low muscle mass and strength) are independently associated with reduced survival, increased treatment toxicities and poorer function. International evidence‐based guidelines exist to guide nutrition screening and interventions. However, despite the severe consequences, little is known about Australian cancer clinicians’ awareness of these conditions and practices relating to their identification and management. This study aimed to determine clinician awareness, understanding and perceptions of malnutrition and sarcopenia in people with cancer.

Methods : A cross‐sectional survey of Australian cancer clinicians was undertaken between November 2018 and January 2019. The 30‐item online survey was circulated through professional organisations and health services.

Results : The 111 participants represented dietetic (38%), nursing (34%), medical (14%) and allied health (14%) clinicians. Overall, 86% and 88% clinicians were aware of accepted definitions of malnutrition and sarcopenia, respectively, with 89% agreeing these were extremely or very important conditions in the overall management of people with cancer. However, perception of responsibility for identification of these conditions varied considerably. Further, 21% and 43% of clinicians had limited or no confidence in their ability to identify malnutrition and sarcopenia, respectively. Greatest barriers to identification and management of malnutrition were access to tools or skills required and lack of services to manage malnourished patients. Greatest barriers to identification and management of sarcopenia were lack of confidence and lack of services to manage patients with sarcopenia.

Conclusions : Awareness of cancer‐related malnutrition and sarcopenia are high among Australian cancer clinicians. The identification and management of these conditions is limited by variation in perceived responsibility, lack of confidence and insufficient services to manage patients with malnutrition or sarcopenia. Work at a national level is required to support cancer clinicians and health services implement optimal nutrition care for people with cancer‐related malnutrition and sarcopenia.