Need for Standardization in Gastrointestinal Cancer

Overview

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Key numbers

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• as physical (n = 21), nutritional (n = 16), and psychological (n = 40) tools. Most tools were brief (1–15 items).
• cancers comprised 24.6% of all new cancer diagnoses and were abstracts.
• responsible for 34.2% of global cancer‐related deaths (1). It is
• and psychological factors (6). Despite the growing recognition “nutrition,” “psychological,” and “exercise” (Table S1).
• title, publication year, study design, GI cancer subtype, and There were 16 (21%) nutritional screening tools identified.
• There were 21 (27%) physical screening tools identified. Physical
• base searches, including EMBASE (n = 1635), MEDLINE domain tools with 40 (52%) tools identified. Psychological
• (n = 799), CINAHL (n = 260), evidence‐based medicine (n = 107), screening tools captured anxiety, depression, resilience, coping,
• and PsycINFO (n = 24). After removal of 429 duplicates, 2396 and broader mental health parameters. Anxiety and depression
• that met all eligibility criteria (see Figure 1 PRISMA diagram). studies (60% of psychological domain). However, these tools
• Characteristics of included studies can be seen in Table 1. Most Although their initial publication dates span from 1921 (Visual
• studies were prospective cohort designs (n = 63, 52%) followed analog scale; VAS) to 2017 (Mini‐Sarcopenia Risk Assessment;
• by retrospective cohort designs (n = 10, 8%). Geographically, MSRA), the majority were introduced between the 1980s and
• sentation of studies being from China (n = 24, 20%), the United often to create abbreviated versions or to facilitate patient self‐
• Kingdom (n = 13, 11%), the United States of America (n = 9, administration (e.g., the Patient‐Generated Subjective Global
• 7%), and Sweden (n = 9, 7%). All screening tools were applied Assessment short form; PG‐SGA‐SF).
• from 1712 to 1687 participants (95) with a median sample size of Scoring approaches varied with most tools generating either a
• nantly colorectal (n = 64, 41%), gastric (n = 26 17%), esophageal whereas several incorporate domain‐specific subscale scoring.
• (n = 14, 10%) and pancreatic (n = 12, 8%) either exclusively or Completion times range from under 5 minutes for concise tools
• Characteristics of tools identified can be seen in Table 2. A total National Comprehensive Cancer Network Distress Thermom-
• Notably, only 17 (14%) studies integrated assessments across 4 | Discussion
• and psychological). Most tools (n = 71, 92%) comprised ≤ 15 This review identifies 77 unique tools from 121 studies. These
• questions and required less than 10 minutes to complete. tools evaluated physical (n = 21), nutritional (n = 16), and
• Recall periods varied widely from “point‐in‐time” assessments psychological (n = 40) domains. Studies originated from 27
• dietary recalls of up to 12 months (e.g., European Prospective studies by design (n = 63, 52%). Although most tools were brief,
• FFQ). However, most tools used a one‐week (46%) or one‐ all three domains within a single tool.
• month (28%) recall period. Response formats were predomi-
• nantly Likert scales (63%) or dichotomous yes/no items (21%) This review demonstrated a wide array of tools but an absence
• with open‐ended diary formats constituting fewer than 5% of of validated, multidomain, and self‐reported tools for GI cancer
• tools. Accessibility was high with 84% of screening tools surgery. Multidomain screening tools offer several advantages
• freely available and 16% requiring licensing or restricted over single‐domain tools. By consolidating assessment across
• Agasi‐Idenburg Prospective exploratory 2016–2018 Lawton Brody scale, 56 67 (median) 64:36 Colorectal
• Burden Prospective cohort study N/A Malnutrition universal 87 64 (range 23–90 years) 62:38 Colorectal
• Casirati Retrospective cohort 2019–2020 Malnutrition universal 100 61 (range 48.5–68) 48:52 Retroperitoneal sarcoma
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Methods (brief)

• sample size. Screening tool attributes were also captured in Nutritional screening tools were often brief (1–18 items).
• between 48 h and 6 weeks preoperatively. Sample sizes ranged
• from 1712 to 1687 participants (95) with a median sample size of Scoring approaches varied with most tools generating either a
• Liedman Prospective cohort study 1984–1991 Body symptom scale (BSS), 33 66 (R 41–82) 65.6:34.4 Gastrointestinal
• mental Activities in Daily Living With Complications and Length of 25. H. Driessens, L. van Wijk, C. I. Buis, and J. M. Klaase, “Low Health
• Haveman, and J. M. Klaase, “A Prospective Cohort Study Evaluating Prediction of Sarcopenia in Patients Scheduled for Gastric and Colo-
• 115. B. Liedman, J. Svedlund, M. Sullivan, L. Larsson, and L. Lundell,

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Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.