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Nutrition in acute and chronic diseases

Comparation of different malnutrition screening tools according to GLIM criteria in cancer outpatients



Many studies have assessed different malnutrition screening tools in oncologic patients. However, very few have been carried out using the new GLIM criteria for malnutrition. The objective of our study is to compare the most recommended screening tools with respect to the new GLIM criteria for malnutrition in cancer patients.


Observational, cross-sectional, and single-center study carried out at the Medical Oncology Department at the Lozano Blesa Hospital in Zaragoza. We recruited 165 patients with tumors of the upper-gastrointestinal-tract, colorectal, and head-and-neck region undergoing outpatient treatment. All of them received MST, MUST, Nutriscore, MNA and CONUT screening tools, as well as the GLIM diagnostic criteria, which was used as the gold standard.


MNA-SF showed the best sensitivity (0.99) and lowest specificity while CONUT had the best specificity (0.89) and lowest sensitivity to detect cancer-related malnutrition. We observed high variability in the diagnostic capabilities of Nutriscore when tumor location was considered, reducing sensitivity in patients with colorectal cancer compared to those with tumors of the upper-gastrointestinal-tract or head-and-neck location (0.25, 0.83, and 0.91 respectively). The highest index of agreement between the screening tools was found between MST, MUST and Nutriscore tests. Regarding the GLIM criteria, the highest agreement index was presented by MUST tool (0.66), while CONUT presented the lowest (0.12).


Selecting the screening tool according to the type of cancer and its location may allow us to optimize its use and increase its performance, exploiting the advantages of each of them in the different populations.

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Fig. 1: GLIM criteria for malnutrition.


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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. JMA-M is partially supported by the project PI17/02268 (Instituto de Salud Carlos III), by Fondo Europeo de Desarrollo Regional (FEDER): “Una manera de hacer Europa”, and by the DGA Group Biology of adipose tissue and metabolic complications (B03_20R), co-financed with the FEDER Aragón 2014-2020: “Construyendo Europa desde Aragón”.

Author information




MG-R: Conceptualization, Methodology, Data Curation, Investigation, Writing-Original draft preparation, Project administration. DC-D: Conceptualization, Methodology, Writing- Original draft preparation. IT-R: Data Curation, Investigation, Methodology. MZ-G: Data Curation, Investigation. NA: Data Curation, Investigation. AS: Data Curation, Investigation. JL: Data Curation, Investigation. MÁ-A: Data Curation, Investigation. EQ: Data Curation, Investigation. DI: Resources, Supervision, Writing – Review &; Editing. JMA-M: Resources, Writing – Review & Editing, Formal analysis.

Corresponding author

Correspondence to Marta Gascón-Ruiz.

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The authors declare no competing interests.

Ethical approval

The Aragón Clinical Research Ethics Committee (CEICA) has evaluated and approved the project with the study code PI19/494 and informed consent was obtained in all patients who agreed to participate in the study.

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Gascón-Ruiz, M., Casas-Deza, D., Torres-Ramón, I. et al. Comparation of different malnutrition screening tools according to GLIM criteria in cancer outpatients. Eur J Clin Nutr (2021).

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