# Oncology nutrition assessment and medical nutrition therapy

Source: https://onco.cc/technologies/nutrition-screening-mnt/  
OnCo record `nutrition-screening-mnt` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Nutrition screening means weighing every patient, asking a few screening questions, and referring those at risk to a dietitian. It is simple, guideline-endorsed, and still not done routinely.

## Summary

Malnutrition affects 20-70% of cancer patients depending on site and stage and independently predicts treatment toxicity, complications, hospital stay and death. ESPEN (2017, 2021) and ASCO (2020) recommend screening all patients at diagnosis and at intervals with a validated tool (MUST, NRS-2002, MST or PG-SGA), followed by assessment of intake, body composition, inflammation and function, and stepwise medical nutrition therapy: dietary counselling, oral nutritional supplements, then artificial nutrition when oral intake fails. Randomised evidence is strongest for dietitian counselling in head and neck and gastrointestinal cancers, where it improves intake, weight and treatment completion. The EFFORT trial in general medical inpatients (Lancet 2019) showed individualised nutrition support reduced mortality, with a cancer subgroup consistent with the overall effect.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Principle: Screen early, before weight loss becomes irreversible; treat the reversible causes (nutrition impact symptoms, inflammation, inactivity) and match support to the patient's prognosis and goals.
- Strengths: Cheap, validated screening tools; Guideline consensus across ESPEN, ASCO, ESMO; Improves treatment completion in head and neck and GI cancers
- Limitations: Screening rates in routine care are low; Dietitian workforce is thin outside large centres; Weight gain does not always mean better survival

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Malnutrition
- ESPEN practical guideline 2021: https://doi.org/10.1016/j.clnu.2021.02.005
- ASCO cachexia guideline 2020: https://doi.org/10.1200/JCO.20.00611
- EFFORT trial (Lancet 2019): https://doi.org/10.1016/S0140-6736(18)32776-4

## Connected records

- ideas: [A dietitian in every gastrointestinal and head and neck tumour board](https://onco.cc/ideas/idea-nl-dietitian-in-every-mdt/), [Ask about diet at diagnosis, and prebunk the myths before the internet does](https://onco.cc/ideas/idea-nl-ask-about-diet-prebunking/), [Confirm or refute the harm of antioxidant supplements during chemotherapy](https://onco.cc/ideas/idea-nl-antioxidant-supplement-harm-confirmation/), [One definitive ketogenic diet trial in glioblastoma, then stop](https://onco.cc/ideas/idea-nl-ketogenic-gbm-definitive-trial/)
- cancers: [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- fronts: [Diet, Exercise & Lifestyle](https://onco.cc/fronts/nutrition-lifestyle/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [CT body composition and sarcopenia measurement](https://onco.cc/technologies/ct-body-composition-sarcopenia/), [Dietary supplements during cancer treatment: interactions and harms](https://onco.cc/technologies/dietary-supplements-treatment-interactions/), [Electronic patient-reported outcome (ePRO) symptom monitoring](https://onco.cc/technologies/epro-symptom-monitoring/), [Fish oil (EPA) for cancer weight loss](https://onco.cc/technologies/omega3-epa-cachexia/), [G8 geriatric screening tool](https://onco.cc/technologies/g8-geriatric-screening/), [Geriatric assessment](https://onco.cc/technologies/geriatric-assessment/), [Muscle and strength after treatment: sarcopenia, cachexia and what rebuilds](https://onco.cc/technologies/muscle-recovery-after-cancer-treatment/), [Nutrition support and cachexia management](https://onco.cc/technologies/oncology-nutrition/)
- terms: [Body composition (lean mass, fat mass, visceral fat)](https://onco.cc/terms/body-composition/), [Cancer cachexia](https://onco.cc/terms/cachexia/), [Malnutrition screening tools (MUST, NRS-2002, MST, PG-SGA)](https://onco.cc/terms/malnutrition-screening/), [Nutrition impact symptoms](https://onco.cc/terms/nutrition-impact-symptoms/), [Pancreatic enzyme replacement therapy (PERT, pancreatin, Creon) for pancreatic exocrine insufficiency: why and how to take it](https://onco.cc/terms/pancreatic-enzyme-replacement/), [Sarcopenia](https://onco.cc/terms/sarcopenia/), [Unproven diet claims (alkaline, juice, 'anti-cancer' diets)](https://onco.cc/terms/unproven-diet-claims/)
- bottlenecks: [Cachexia, toxicity and the limits of the patient](https://onco.cc/bottlenecks/b-cachexia-supportive/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/)
- key papers: [ESPEN practical guideline: Clinical Nutrition in cancer](https://onco.cc/key-papers/paper-muscaritoli-clin-nutr/), [Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial](https://onco.cc/key-papers/paper-schuetz-lancet/), [Management of Cancer Cachexia: ASCO Guideline](https://onco.cc/key-papers/paper-roeland-j-clin-oncol/)
- roadmaps: [Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment](https://onco.cc/roadmaps/nutrition-lifestyle-roadmap/)

---
JSON: https://onco.cc/api/v1/entities/nutrition-screening-mnt.json