NUTRITIONAL RISK SCREENING IN ONCOLOGY: A COMPARATIVE STUDY OF TWO INSTRUMENTS

Resumo

Malnutrition in cancer patients often remains underdiagnosed, especially in outpatient settings, where much of the clinical follow -up takes place. In this context, the use of validate d nutritional screening tools is essential for the early identification of individuals at risk. Among the available instruments, the Nutrition Risk Screening 2002 (NRS-2002) and the Patient-Generated Subjective Global Assessment Short Form (PG -SGA SF) stan d out. However, evidence remains divergent regarding the most appropriate instrument for nutritional identification in these patients. In light of the above, this study aimed to compare the performance of the NRS -2002 and PG -SGA SF instruments in identifying nutritional risk among cancer patients undergoing outpatient follow-up. This study is part of a broader investigation previously approved by a Research Ethics Committee, protocol no. 7.873.565. This is an observational, analytical, cross -sectional study conducted with patients admitted to the oncology center of a hospital located in the midwestern region of the state of São Paulo, Brazil. Individuals aged 18 years or older, of both sexes, with a confirmed cancer diagnosis were included. Nutritional scree ning was performed by an experienced professional using the NRS - 2002 and PG -SGA SF instruments. For data analysis, the classifications of moderate nutritional risk and high nutritional risk obtained through the PG- SGA SF were grouped into a single catego ry, named nutritional risk, in order to enable comparison with the NRS -2002 classification. Functional performance was assessed using the Eastern Cooperative Oncology Group Performance Status scale (ECOG -PS). Sociodemographic and clinical variables, such a s age, sex, type of neoplasm, and clinical staging, were also collected. Statistical analysis included descriptive measures and the chi- square test using Jamovi software, version 2.6.44, considering a 5% significance level. The sample consisted of 52 pati ents, with a predominance of females (63.5%) and a mean age of 59 ± 14.8 years. Heterogeneity was observed regarding tumor types, with breast cancer being the most frequent (40.4%), in addition to a high proportion of patients in advanced stages of the dis ease (57.7% in stages III and IV). Regarding functional performance, 96.1% presented good general status, classified as ECOG-PS 0-1. Based on the NRS-2002, 38.5% of patients were classified as being at nutritional risk, whereas according to the PG-SGA SF, 46% were at nutritional risk. Among the evaluated patients, 31.3% of those classified as not being at nutritional risk by the NRS -2002 were considered at risk by the PG -SGA SF. This difference in nutritional risk classification according to the instruments used was significant (p = 0.006). These findings allow us to conclude that, in the studied sample, the PG -SGA SF was able to identify a higher proportion of patients at risk when compared with the NRS -2002, proving to be more appropriate for the early detection of nutritional impairment. Its use in clinical practice may support more timely and effective interventions. Future studies should evaluate the impact of these instruments on clinical outcomes.