Food Security and Malnutrition Status in Patients with Cancer: an Australian Cross-Sectional Survey

Background: Food insecurity is an important but under-recognised issue in cancer patients. It is linked to malnutrition and contributes to inequities in care. As there is minimal national population data available, this study aimed to assess the food security status of people receiving treatment for cancer in the state of Victoria, Australia. Methods: A multi-site point prevalence study was conducted in Victorian acute health services in July 2024. Adults receiving ambulatory treatment and multi-day stay inpatients were included. Patients were screened and assessed for malnutrition (using the Malnutrition Screening Tool and Global Leadership Initiative on Malnutrition criteria) and assessed for their food security status (using the Household Food Security Survey Module for Adults). Results: A total of 24 health services recruited 2121 adults with cancer. Overall, 6.9% experienced food insecurity, with the majority (52.4%) experiencing marginal food insecurity. No differences in food security status were observed between admitted and ambulatory patients, nor between metropolitan and regional/rural locations. Culturally and linguistically diverse (CALD) patients recorded higher rates of food insecurity compared to non-CALD patients (10.4% vs. 6.0%; p = 0.001). Patients who were food insecure had a higher prevalence of malnutrition compared to food secure patients (37.4% vs. 27.5%; p = 0.014). Conclusions: Although the prevalence of food security was low overall among patients with cancer, it was more pronounced in patients with malnutrition or from CALD backgrounds. To effectively address the issue of malnutrition in patients with cancer, food security must be considered as part of a multi-modal intervention.