# Nutritional Status of Patients Diagnosed with Cervical Cancer in Tanzania

## TL;DR

This study finds that many Tanzanian women with cervical cancer, especially those in late stages, suffer from malnutrition, highlighting the need for targeted nutritional support.

## Contribution

The study is the first to evaluate the nutritional status of cervical cancer patients in Tanzania, revealing high rates of malnutrition linked to cancer stage.

## Key findings

- 84.8% of patients required nutritional intervention based on their nutritional status.
- Late-stage cervical cancer patients showed significantly higher rates of malnutrition compared to early-stage patients.
- Late-stage patients had higher levels of white blood cells, platelets, and liver enzymes, indicating worse health outcomes.

## Abstract

Cervical cancer is the most common cancer affecting Tanzanian women. The nutritional status of patients with cervical cancer may influence cervical cancer outcomes. However, no information is available regarding the nutritional status of the Tanzanian cervical cancer patients. Therefore, we evaluated the nutritional status of patients with cervical cancer treated at the Ocean Road Cancer Institute (ORCI) in Tanzania.

We conducted a cross-sectional study of 184 newly diagnosed patients with cervical cancer seen at the oncology clinic of ORCI from April to September 2023. Assessment of the nutritional status was based on the Patient-Generated Subjective Global Assessment (PG-SGA) scores. The overall nutritional status was evaluated using nutritional blood biomarkers, food intake frequencies, a categorical rating indicating the level of malnourishment, and a triage recommendation. Multivariate regression analysis was performed to predict nutritional status based on demographic and clinical variables.

Among the total patient population, 39.1% reported consuming less food after diagnosis, especially the intake of cereals, dark leafy green vegetables, orange vegetables, other vegetables, as well as oils, and fats. The majority (84.8%) of patients required nutritional intervention based on their nutritional status. Almost half (48%) of patients with early-stage cervical cancer (stages I, II) and 78% of patients with late-stage cervical cancer (Stage III, IV), showed moderate or severe malnutrition. The risk of malnutrition was significantly higher in patients with late-stage vs early-stage cancer (8.0 ± 1.4 vs. 5.9 ± 0.8; p = 0.0173). Similarly, patients with late-stages had higher mean levels of white blood cells (late vs. early: 9.0 ± 1.1 vs. 7.6 ± 0.6; p = 0.0216), platelets (396.3 ± 39.4 vs. 347.5 ± 23.9; p = 0.0399), the ratio of platelet to neutrophil count (101.7 ± 13.8 vs. 82.3 ± 1.6; p = 0.0294), and the liver function test, aspartate aminotransferase (AST) enzyme (31.9 ± 5.9 vs. 24.5 ± 2.0; p = 0.0201). Late-stage patients were predicted to have a worse nutritional status (late vs. early: mean = 7.8 vs. 6.0, p = 0.04), after adjusting for sociodemographic covariates. Further adjustments by smoking, alcohol use and physical activity did not affect the model.

Nutritional status of patients with late-stage cervical cancer in Tanzania should be prioritized during the management of patients with cervical cancer, especially for late-stage patients. This study may have translation to other low-income countries facing challenges in cancer management, poverty, and challenges in food security.