Non-Cochrane · prognostic · PM42656371
Prevalence of malnutrition and nutritional risk, and associated factors in adults with head and neck cancer: a systematic review and meta-analysis.
Li Qianqian, Chen Yin, Chen Chunxiang, et al. · Frontiers in oncology · 2026 · PubMed · doi:10.3389/fonc.2026.1905663
Findings
32 findings
| Population | ||||
|---|---|---|---|---|
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of NRS 2002-defined nutritional risk Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | Prevalence 32.0 [18.9, 48.7] GRADE not reported 6 studies · 1423 participants |
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of PG-SGA-based nutritional category (malnutrition) Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | Prevalence 57.8 [37.7, 75.7] GRADE not reported 6 studies · 724 participants |
| Adults (18 years or older) with head and neck cancer free of the specified nutritional outcome at baseline | None (incidence) | None | Incidence (prospective prevalence) of new malnutrition or nutritional risk Follow-up · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | Pooled prevalence was planned only for prospective cohorts in which participants were free of the specified outcome at baseline and new cases were observed during follow-up; no included report met this definition. No studies found 0 studies |
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of GLIM-defined malnutrition Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | Prevalence 39.4 [30.4, 49.1] GRADE not reported 5 studies · 1158 participants |
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of PG-SGA-based nutritional category (malnutrition) Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: Freeman-Tukey double-arcsine transformation | Prevalence 57.8 [39.0, 75.4] GRADE not reported 6 studies · 724 participants |
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of NRS 2002-defined nutritional risk Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: Freeman-Tukey double-arcsine transformation | Prevalence 33.3 [20.2, 47.8] GRADE not reported 6 studies · 1423 participants |
| Adults (18 years or older) with head and neck cancer | None (prevalence) | None | Prevalence of GLIM-defined malnutrition Earliest eligible assessment per study (pre-treatment, during treatment or perioperative) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: Freeman-Tukey double-arcsine transformation | Prevalence 39.6 [30.5, 49.0] GRADE not reported 5 studies · 1158 participants |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: leave-one-out omitting Hu et al., 2025 | OR 1.493 [1.074, 2.074] GRADE not reported 4 studies |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: leave-one-out omitting Guangxi NPC, 2024 | OR 1.879 [1.462, 2.417] GRADE not reported 4 studies |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: leave-one-out omitting Wang GLIM, 2023 | OR 1.600 [1.083, 2.364] GRADE not reported 4 studies |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: leave-one-out omitting Oral Periop, 2023 | OR 1.530 [1.067, 2.194] GRADE not reported 4 studies |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: leave-one-out omitting Oral Postop, 2024 | OR 1.654 [1.099, 2.489] GRADE not reported 4 studies |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 1.613 [1.167, 2.229] GRADE not reported 5 studies · 1231 participants |
| Adults (18 years or older) with head and neck cancer | Advanced age | Younger age | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 1.613 [1.020, 2.550] GRADE not reported 5 studies · 1231 participants |
| Adults (18 years or older) with head and neck cancer | Low body mass index | Normal body mass index | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 1.462 [1.138, 1.878] GRADE not reported 3 studies · 997 participants |
| Adults (18 years or older) with head and neck cancer | Low body mass index | Normal body mass index | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 1.462 [1.316, 1.624] GRADE not reported 3 studies · 997 participants |
| Adults (18 years or older) with head and neck cancer | Smoking | Non-smoking | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 1.697 [0.843, 3.414] GRADE not reported 3 studies · 493 participants |
| Adults (18 years or older) with head and neck cancer | Smoking | Non-smoking | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 1.697 [1.342, 2.145] GRADE not reported 3 studies · 493 participants |
| Adults (18 years or older) with head and neck cancer | Anxiety and/or depression | No anxiety or depression | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 2.309 [1.739, 3.066] GRADE not reported 4 studies · 781 participants |
| Adults (18 years or older) with head and neck cancer | Anxiety and/or depression | No anxiety or depression | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 2.309 [1.457, 3.659] GRADE not reported 4 studies · 781 participants |
| Adults (18 years or older) with head and neck cancer | Low serum albumin | Normal serum albumin | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 1.192 [1.116, 1.274] GRADE not reported 4 studies · 1372 participants |
| Adults (18 years or older) with head and neck cancer | Low serum albumin | Normal serum albumin | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 1.192 [0.996, 1.427] GRADE not reported 4 studies · 1372 participants |
| Adults (18 years or older) with head and neck cancer | Low hemoglobin | Normal hemoglobin | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 2.460 [1.397, 4.333] GRADE not reported 3 studies · 524 participants |
| Adults (18 years or older) with head and neck cancer | Low hemoglobin | Normal hemoglobin | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 2.460 [0.553, 10.946] GRADE not reported 3 studies · 524 participants |
| Adults (18 years or older) with head and neck cancer | Dysphagia | No dysphagia | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 2.687 [1.425, 5.067] GRADE not reported 3 studies · 499 participants |
| Adults (18 years or older) with head and neck cancer | Dysphagia | No dysphagia | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 2.687 [2.012, 3.587] GRADE not reported 3 studies · 499 participants |
| Adults (18 years or older) with head and neck cancer | Advanced tumor stage (III-IV) | Early tumor stage | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 2.516 [1.683, 3.760] GRADE not reported 4 studies · 1020 participants |
| Adults (18 years or older) with head and neck cancer | Advanced tumor stage (III-IV) | Early tumor stage | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 2.516 [1.964, 3.222] GRADE not reported 4 studies · 1020 participants |
| Adults (18 years or older) with head and neck cancer | Radiotherapy or chemoradiotherapy | No radiotherapy or chemoradiotherapy | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 2.473 [1.627, 3.757] GRADE not reported 4 studies · 901 participants |
| Adults (18 years or older) with head and neck cancer | Radiotherapy or chemoradiotherapy | No radiotherapy or chemoradiotherapy | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 2.473 [1.911, 3.200] GRADE not reported 4 studies · 901 participants |
| Adults (18 years or older) with head and neck cancer | Prolonged tube feeding | No prolonged tube feeding | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) · Sensitivity analysis: modified Hartung-Knapp small-sample correction | OR 1.485 [0.508, 4.338] GRADE not reported 3 studies · 341 participants |
| Adults (18 years or older) with head and neck cancer | Prolonged tube feeding | No prolonged tube feeding | Malnutrition or nutritional risk (GLIM, PG-SGA, NRS 2002 or source-defined) Concurrent or baseline assessment (temporal sequence varies by study) · Hospital-based HNC cohorts (China, Taiwan, Europe, Australia, Morocco, Brazil, India) | OR 1.485 [0.911, 2.419] GRADE not reported 3 studies · 341 participants |
Included primary studies 20
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chen 2023 DOI:10.19438/j.cjoms.2023.06.002 | NR | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Deng 2023 Malnutrition in patients with head and neck cancer undergoing radiotherapy: A cross-sectional study. PMID:37611500 | 2023 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
| Einarsson 2020 Mapping impact factors leading to the GLIM diagnosis of malnutrition in patients with head and neck cancer. PMID:33183529 | 2020 | this review only | Prevalence of GLIM-defined malnutrition | not extracted yet |
| Hu 2025 Analysis of nutritional status and its influencing factors in patients with head and neck cancer: An observational study. PMID:40826729 | 2025 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
| Kuang 2025 Predicting postoperative malnutrition in patients with oral cancer: development of an XGBoost model with SHAP analysis and web-based… PMID:40421091 | 2025 | this review only | not stated | not extracted yet |
| Lima 2026 Associations of nutritional risk, pre-treatment malnutrition, and cachexia with mortality, local recurrence, and metastasis in head and… DOI:10.1186/s12885-025-15373-5 | 2026 | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Liu 2024 Correlation Analysis Between Prognostic Nutritional Index Trajectory Categories and Radiotherapy-induced Severe Oral Mucositis in Head and… PMID:39665402 | 2024 | this review only | not stated | not extracted yet |
| Noronha 2025 Nutritional status and impact on outcomes of patients with locally advanced head and neck squamous cell carcinoma treated with concurrent… PMID:40717193 | 2025 | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Orell 2022 GLIM in diagnosing malnutrition and predicting outcome in ambulatory patients with head and neck cancer. PMID:36483923 | 2022 | this review only | Prevalence of GLIM-defined malnutrition | not extracted yet |
| Steer 2020 Malnutrition Prevalence according to the GLIM Criteria in Head and Neck Cancer Patients Undergoing Cancer Treatment. PMID:33203000 | 2020 | this review only | Prevalence of GLIM-defined malnutrition | not extracted yet |
| Taouchikht 2024 Evaluating Nutritional Health in Cases of Head and Neck Cancer Receiving Radiotherapy DOI:10.38124/ijisrt/ijisrt24aug437 | 2024 | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Tsai 2020 Association of malnutrition with postoperative complication risk after curative surgery for oral cancer: Observational study. PMID:33350779 | 2020 | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Tu 2024 Application of NRS2002 and PG-SGA in nutritional assessment for perioperative patients with head and neck squamous cell carcinoma: An… PMID:39470500 | 2024 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
| Vilchez-Lopez 2024 Predictive Factors of the Degrees of Malnutrition According to GLIM Criteria in Head and Neck Cancer Patients: Valor Group. PMID:39766154 | 2024 | this review only | Prevalence of GLIM-defined malnutrition | not extracted yet |
| Wang 2023 (NPC, GLIM) Risk factors for malnutrition in patients with nasopharyngeal carcinoma. PMID:38008866 | 2023 | this review only | Prevalence of GLIM-defined malnutrition | not extracted yet |
| Wang 2023 (oral cancer) Perioperative nutritional risk and its influencing factors in patients with oral cancer: a longitudinal study. PMID:37426177 | 2023 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
| Wang 2024 (NPC nomogram) Risk factors and the nomogram model for malnutrition in patients with nasopharyngeal carcinoma DOI:10.1007/s00520-024-08459-6 | 2024 | this review only | not stated | not extracted yet |
| Wang 2024 (NPC, NRS 2002) Nutritional risk factors in patients with nasopharyngeal carcinoma: a cross-sectional study. PMID:38832098 | 2024 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
| Zhan 2025 Risk Factors of Malnutrition in Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy and Construction of a Predictive Model. PMID:41485969 | 2025 | this review only | Prevalence of PG-SGA-based nutritional category (malnutrition) | not extracted yet |
| Zhu 2025 A dynamic online nomogram for predicting nutritional risk in nasopharyngeal carcinoma patients after radiotherapy. PMID:40434547 | 2025 | this review only | Prevalence of NRS 2002-defined nutritional risk | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (>=18 years) with head and neck cancer (oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, other) | Adults with head and neck cancer (n=4,456; 20 studies); HNC overall 10, NPC 5, oral cancer 4, laryngeal/hypopharyngeal 1 |
| Intervention | Demographic, behavioral, biochemical, functional, tumor-related, treatment-related or psychosocial associated variables | Advanced age; low BMI; smoking; anxiety/depression; low albumin; low hemoglobin; dysphagia; advanced tumor stage; radiotherapy/chemoradiotherapy; prolonged tube feeding |
| Comparison | Non-exposed or lower-risk reference category in each study | Younger age; normal BMI; non-smoking; no anxiety/depression; normal albumin and hemoglobin; no dysphagia; early stage; no radiotherapy; no prolonged tube feeding |
| Outcomes | GLIM-defined malnutrition; NRS 2002-defined nutritional risk; PG-SGA-based nutritional categories; prospective incidence | GLIM-defined malnutrition (n=5 studies, 1,158); PG-SGA-based categories (n=6, 724); NRS 2002 nutritional risk (n=6, 1,423); associated-factor ORs (3 to 5 studies each) |
| Study designs | Observational studies (cross-sectional, cohort, case-control, longitudinal) and secondary analyses of RCTs | Cross-sectional 8; prospective cohort 4; retrospective cohort 3; longitudinal 3; secondary RCT analysis 1; unspecified observational 1 |
| Timing | Not specified | Assessment time points varied (baseline, perioperative, during or after radiotherapy) |