Cancer-associated anorexia: Validity and performance overtime of different appetite tools among patients at their first cancer diagnosis

Alessio Molfino, Marian A. E. de van der Schueren, Karla Sánchez-Lara, Pilar Milke, Maria Ida Amabile, Giovanni Imbimbo, Luca di Lazzaro, Silvio Cavuto, Giovanni Ronzani, Anton Snegovoy, Ioannis Gioulbasanis, Alessandro Laviano*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background & aims: Anorexia is a frequent symptom in cancer and we aimed to assess its prevalence among patients at their first cancer diagnosis by different appetite tools and the relationship between each tool with self-reports of food intake. We also tested whether cancer anorexia influences outcomes independently of reduced food intake or body weight loss (BWL) overtime and whether BWL was associated with complications during anticancer-therapy. Methods: Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score, self-assessment of appetite, Anorexia Questionnaire (AQ) and Visual Analog Scale (VAS) were administered. Percent of food intake was used as a criterion measure of anorexia. We registered BWL and anticancer-therapy complications over 3-month-follow-up. Results: 438 cancer patients from 7 cancer-centers worldwide were included. The prevalence of anorexia was 39.9% by FAACT score, 40.2% by VAS, 40.6% by the self-assessment of appetite and 65.4% by AQ. Low food intake (≤50%) was reported in 28% of patients. All appetite tools correlated with food intake percent (P < 0.0001). We documented a correlation between self-assessment of appetite, FAACT score, VAS and BWL overtime (P < 0.04). The self-assessment of appetite (P = 0.0152) and the FAACT score (P = 0.043) were associated with BWL independently of anticancer therapies. Among patients with BWL, the risk to develop complications was greater with respect to those who maintained a stable or gained body weight (P = 0.03). Conclusions: In our sample of cancer patients, FAACT score and self-assessment of appetite performed well when low food intake was used as a criterion measure, and revealed an association of anorexia with BWL, which was, in turn, related to the development of anticancer-therapy complications.

Original languageEnglish
Pages (from-to)4037-4042
Number of pages6
JournalClinical Nutrition
Issue number6
Early online date2021
Publication statusPublished - Jun 2021

Cite this