Risk of Malnutrition in Digestive System Cancers: A Systematic Review and Meta-Analysis.

Area of Science:

• Oncology
• Gastroenterology
• Nutritional Science

Background:

• Malnutrition is prevalent in gastrointestinal (GI) cancer patients, significantly impacting prognosis.
• Identifying risk factors for malnutrition is crucial for improving patient outcomes.
• Existing data on malnutrition risk factors in GI cancer is varied, necessitating a comprehensive analysis.

Purpose of the Study:

• To conduct a meta-analysis identifying risk factors for malnutrition risk, diagnosis, and cachexia in GI cancer patients.
• To analyze the influence of patient demographics, tumor characteristics, and biomarkers on malnutrition.
• To highlight the need for standardized nutritional assessment protocols in this population.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library databases up to October 31, 2025.
• Inclusion of studies reporting risk factors for malnutrition, malnutrition-related complications, and cachexia in adult GI cancer patients.
• Random-effects model meta-analysis to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for identified risk factors.

Main Results:

• Analysis included data from 262,525 patients across 578 articles.
• Older age (≥65) was a significant risk factor for malnutrition across all GI cancers.
• Elevated C-reactive protein and specific tumor locations (e.g., pancreatic head, right-sided colon) were associated with increased malnutrition risk or complications.

Conclusions:

• Inflammatory biomarkers and tumor characteristics are key indicators of malnutrition risk in GI cancer patients at baseline.
• Older age and male sex (in gastric cancer) are significant demographic risk factors.
• There is an urgent need for standardized and harmonized nutritional status assessment methods in GI cancer care.