Global prevalence and moderating factors of malnutrition in colorectal cancer survivors: A meta-analysis

Purpose: This meta-analysis aims to estimate the global prevalence of severe, moderate, overall malnutrition and moderating factors of malnutrition in colorectal cancer (CRC) survivors. Methods: A comprehensive search was conducted in Embase, CINAHL, Medline-OVID, PubMed, Scopus, and Web of Science from inception to February 8, 2024, without language, region, or publication date restrictions. A generalized linear mixed model and random-effects model were used to examine the pooled prevalence, and moderator analyses were implemented to investigate variations in the pooled prevalence. Results: In 35 studies involving 9,278 colorectal cancer survivors, the global prevalence was 12.10% for severe malnutrition (95% confidence interval (CI): 7.28–16.92; n = 507), 33.13% for moderate malnutrition (95% CI: 28.93–37.34; n: 2,192), and 47.78% for overall malnutrition (95% CI: 41.60–53.96; n: 3,812). Asia showed higher rates of severe malnutrition 16.67% (95% CI: 4.66–28.68, n: 232) and overall malnutrition 53.17% (95% CI: 39.66–66.69, n: 1,913), whereas low-middle income countries demonstrated higher rates of overall malnutrition 67.46% (95% CI: 30.25–100.00, n: 82). Male sex, colon cancer, advanced stage, metastasis, chemotherapy, surgery, adjuvant treatment, smoking, alcohol consumption, hypertension, and diabetes significantly moderated overall malnutrition prevalence. Conclusions: This meta-analysis reports detailed data on the global prevalence of CRC survivors experience malnutrition, highlighting that health-care professionals should consider the identified moderating factors. Implications for cancer survivors: Addressing malnutrition in CRC survivors is critical, as early and proactive nutritional management can enhance recovery, improve quality of life, and potentially reduce cancer-related complications associated with malnutrition.