Main Article Content


Introduction: The global prevalence of children with cancer continues to increase, reaching 186.6 per 1 million children aged 0-19 years. Children with cancer face challenges in fulfilling nutrition due to increased energy needs due to disease and treatment side effects. Nutritional assessment using nutrition screening tools is currently highly variable and varies across health institutions. This study aims to critically describe the assessment of nutritional screening tools in ensuring suitability and sensitivity as well as advantages and disadvantages in identifying the nutritional needs of children with cancer. Methods: PRISMA was used as a guide in preparing a systematic literature review based on inclusion criteria to determine research articles, search strategies, and research findings. Databases used in this study included Pubmed and Science Direct. Results: The use of appropriate nutrition screening tools is essential for assessing the nutritional status of pediatric patients with cancer. Appropriate nutrition screening tools have a positive impact on the nutritional fulfillment of children with cancer. There are five different nutrition screening tools in assessing the sensitivity of nutrition screening tools in children with cancer and their advantages and disadvantages. The sensitivity of the Screening Tool for Childhood Cancer (SCAN) and the Pediatric Yorkhill Malnutrition Score (PYMS) was highly accurate in correctly identifying children with cancer at risk of malnutrition. Conclusions: This finding is expected to be a recommendation for health workers in choosing the right nutrition screening tool to monitor the nutritional status of pediatric patients with cancer during treatment.

Article Details

How to Cite
Farlina, M., Mansur, A. R., Sari, I. M., Herien, Y., Deswita, Neherta, M., & Sukma, N. P. (2024). Assessment of Nutrition Screening Tools in Pediatric Oncology: A Systematic Review. Basic and Applied Nursing Research Journal, 5(1), 1-16.


1. E. Ward, C. DeSantis, A. Robbins, B. Kohler, and A. Jemal, “Childhood and adolescent cancer statistics, 2014,” CA. Cancer J. Clin., vol. 64, no. 2, pp. 83–103, 2014, doi: 10.3322/caac.21219.
2. L. Inhestern et al., “Estimates of prevalence rates of cancer patients with children and well-being in affected children: a systemat-ic review on population-based findings,” Front. Psychiatry, vol. 12, 2021, doi: 10.3389/fpsyt.2021.765314.
3. J. Bauer, H. Jürgens, and M. Frühwald, “Im-portant aspects of nutrition in children with cancer,” Adv. Nutr., vol. 2, no. 2, pp. 67–77, 2011, doi: 10.3945/an.110.000141.
4. A. Sala, P. Pencharz, and R. Barr, “Children, cancer, and nutrition—a dynamic triangle in review,” Cancer, vol. 100, no. 4, pp. 677–687, 2004, doi: 10.1002/cncr.11833.
5. P. N et al., “Oral/enteral nutritional sup-plementation in children treated for can-cer in low-middle-income countries is fea-sible and effective: the experience of the children’s hospital manuel de jesus rivera ‘la mascota’ in nicaragua,” Mediterr. J. He-matol. Infect. Dis., vol. 10, no. 1, p. 2018038, 2018, doi: 10.4084/mjhid.2018.038.
6. B. Sudarmanto and C. Primavita, “Disease-related malnutrition in children with can-cer: what’s the risk and the impact on pa-tient’s outcome?,” World Nutr. J., vol. 5, no. 2, pp. 42–51, 2022, doi: 10.25220/wnj.v05.i2.0007.
7. M. Napartuk et al., “Improvement of diet after an early nutritional intervention in pediatric oncology,” Children, vol. 10, no. 4, p. 667, 2023, doi: 10.3390/children10040667.
8. V. Bélanger et al., “Early nutritional inter-vention to promote healthy eating habits in pediatric oncology: a feasibility study,” Nu-trients, vol. 14, no. 5, p. 1024, 2022, doi: 10.3390/nu14051024.
9. J. Franke, C. Bishop, and D. Runco, “Malnu-trition screening and treatment in pediat-ric oncology: a scoping review,” BMC Nutr., vol. 8, no. 1, 2022, doi: 10.1186/s40795-022-00643-3.
10. A. Hegazy, H. Bar, S. Alamri, F. Almahmoudi, W. Ghamdi, and E. Abdulga-der, “Quality of life in pediatric cancer pa-tients,” J. Adv. Med. Med. Res., pp. 1–11, 2019, doi: 10.9734/jammr/2019/v30i1030243.
11. W. Han et al., “Implementation of a nutri-tion screening tool to improve nutritional status of children with cancer in singa-pore’s largest paediatric hospital,” BMJ Open Qual., vol. 10, no. 1, p. 000944, 2021, doi: 10.1136/bmjoq-2020-000944.
12. D. Robinson, D. Loman, K. Balakas, and M. Flowers, “Nutritional screening and early intervention in children, adolescents, and young adults with cancer,” J. Pediatr. Oncol. Nurs., vol. 29, no. 6, pp. 346–355, 2012, doi: 10.1177/1043454212460921.
13. A. Murphy, M. White, K. Viani, and T. Mos-by, “Evaluation of the nutrition screening tool for childhood cancer (scan,” Clin. Nutr., vol. 35, no. 1, pp. 219–224, 2016, doi: 10.1016/j.clnu.2015.02.009.
14. D. Bicakli and M. Kantar, “Comparison of malnutrition and malnutrition screening tools in pediatric oncology patients: A cross-sectional study,” Nutrition, vol. 86, p. 111142, 2021, doi: 10.1016/j.nut.2021.111142.
15. R. Iniesta et al., “Nutritional status of chil-dren and adolescents with cancer in Scot-land: A prospective cohort study,” Clin. Nutr. ESPEN, vol. 32, pp. 96–106, 2019, doi: 10.1016/j.clnesp.2019.04.006.
16. I. Munoz, C. I. Benitez, C. Gavilan, L. Rodri-guez, and V. Trujillo, “Validation of the SCAN nutritional screening tool for child-hood cancer. Spanish version,” Nutr. Friendly, vol. 40, no. 2, pp. 295–302, 2022, doi: 10.20960/nh.04369.
17. N. Ouyang, L. Xia, R. Cai, M. Liu, and K. Liu, “Nutritional screening and assessment, and quality of life in children with cancer: a cross-sectional study in mainland china,” J. Pediatr. Nurs., vol. 57, pp. 99–105, 2021, doi: 10.1016/j.pedn.2020.07.013.
18. A. Lovell, “Nutrition screening, assessment, and intervention practices for children with cancer in aotearoa, new zealand,” Nu-trition, vol. 116, p. 112218, 2023, doi: 10.1016/j.nut.2023.112218.
19. C. Gallo, A. Belardo, and I. Cioffi, “Different nutritional screening tools and recom-mended screening algorithm for pediatric oncology patients,” Nutrition, vol. 40, pp. 3836–3841, 2021, doi: 10.1016/j.clnu.2021.05.013.
20. A. Yoruk, Ç. Durakbaşa, Ç. Timur, Ş. Şahin, and E. Taşkın, “Assessment of nutritional status and malnutrition risk at diagnosis and over a 6-month treatment period in pediatric oncology patients with hemato-logic malignancies and solid tumors,” J. Pe-diatr. Hematol. Oncol., vol. 41, no. 5, pp. 308–321, 2019, doi: 10.1097/mph.0000000000001350.
21. D. Glatt et al., “Nutritional screening and assessment of paediatric cancer patients: a quality improvement project (baseline re-sults,” Clin. Nutr. Espen, vol. 38, pp. 242–252, 2020, doi: 10.1016/j.clnesp.2020.04.003.
22. L. Henry, “Nutritional assessment and die-tetic resource for children and young peo-ple with cancer in the united kingdom,” Pediatr. Blood Cancer, vol. 69, no. 9, 2022, doi: 10.1002/pbc.29743.
23. C. Kuehni et al., “Cohort profile: the swiss childhood cancer survivor study,” Int. J. Ep-idemiol., vol. 41, no. 6, pp. 1553–1564, 2011, doi: 10.1093/ije/dyr142.
24. A. Mariotto et al., “Long-term survivors of childhood cancers in the united states,” Cancer Epidemiol. Biomarkers Prev., vol. 18, no. 4, pp. 1033–1040, 2009, doi: 10.1158/1055-9965.epi-08-0988.
25. A. Nagayama et al., “Metreleptin supple-mentation for improving lipid and glyce-mic profiles in acquired diabetes lipo-dystrophy: a case report,” J. Endocr. Soc., vol. 3, no. 11, pp. 2179–2183, 2019, doi: 10.1210/js.2019-00251.
26. E. Ladas, B. Arora, S. Howard, P. Rogers, T. Mosby, and R. Barr, “A framework for adapted nutritional therapy for children with cancer in low- and middle-income countries: a report from the siop podc nu-trition working group,” Pediatr. Blood Can-cer, vol. 63, no. 8, pp. 1339–1348, 2016, doi: 10.1002/pbc.26016.
27. M. Karalexi et al., “Nutritional status at di-agnosis as predictor of survival from childhood cancer: a review of the litera-ture,” Diagnostics, vol. 12, no. 10, p. 2357, 2022, doi: 10.3390/diagnostics12102357.
28. F. Zhang et al., “Assessing dietary intake in childhood cancer survivors,” J. Pediatr. Gastroenterol. Nutr., vol. 61, no. 4, pp. 499–502, 2015, doi: 10.1097/mpg.0000000000000826.
29. C. Fleming, A. Murphy-Alford, J. Cohen, M. Fleming, C. Wakefield, and F. Naumann, “Poor diet quality and adverse eating be-haviours in young survivors of childhood cancer.” 2021. doi: 10.22541/au.161107475.55687074/v1.
30. R. Murray, B. Brennan, R. Ahmadi, and S. Shalet, “Survivors of child-hood cancer: long-term endocrine and metabolic prob-lems dwarf the growth disturbance,” Re-habil. Oncol., vol. 19, no. 2, p. 29, 2001, doi: 10.1097/01893697-200119020-00024.
31. M. Nassar, M. Abdel-Wahed, B. Abdel-haleem, A. Ahmed, and H. Kholy, “Outpa-tient nutritional screening and rehabilita-tion of malnourished egyptian children: are rural areas at more risk?” 2022. doi: 10.21203/
32. C. Xavier, J. Freitas, T. Miola, and A. Firmino, “Comparison of different nutri-tional screening tools in pediatric oncolo-gy.” 2022. doi: 10.21203/
33. L. DeLoid, A. Peabody, and S. Edelstein, “Incidence of nutritional assessment, in-tervention, and follow-up for pediatric pa-tients with cancer,” Top. Clin. Nutr., vol. 25, no. 1, pp. 3–8, 2010, doi: 10.1097/tin.0b013e3181d10920.
34. L. Carter et al., “Screening for pediatric malnutrition at hospital admission: which screening tool is best?,” Nutr. Clin. Pract., vol. 35, no. 5, pp. 951–958, 2019, doi: 10.1002/ncp.10367.
35. F. Fabozzi et al., “Management of nutri-tional needs in pediatric oncology: a con-sensus statement,” Cancers, vol. 14, no. 14, p. 3378, 2022, doi: 10.3390/cancers14143378.
36. K. Montgomery et al., “Perceptions of nu-trition support in pediatric oncology pa-tients and parents,” J. Pediatr. Oncol. Nurs., vol. 30, no. 2, pp. 90–98, 2013, doi: 10.1177/1043454212471726.
37. G. Pugh, A. Lovell, S. Laughton, and A. Wood, “Nutrition screening, assessment and intervention practices for children with cancer in aotearoa, new zealand.” 2023. doi: 10.22541/au.168058803.38437624/v1.
38. P. Tandon, M. Raman, M. Mourtzakis, and M. Merli, “A practical approach to nutri-tional screening and assessment in cirrho-sis,” Hepatology, vol. 65, no. 3, pp. 1044–1057, 2017, doi: 10.1002/hep.29003.
39. Y. Lee and H. Yang, “Comparison of four nutritional screening tools for korean hos-pitalized children,” Nutr. Res. Pract., vol. 13, no. 5, p. 410, 2019, doi: 10.4162/nrp.2019.13.5.410.
40. F. Roulston and R. McDermott, “Compari-son of three validated nutritional screen-ing tools in the oncology setting,” Proc. Nutr. Soc., vol. 67, no. OCE7, 2008, doi: 10.1017/s0029665108009233.
41. H. McCarthy, M. Dixon, I. Crabtree, M. Eaton-Evans, and H. McNulty, “The devel-opment and evaluation of the screening tool for the assessment of malnutrition in paediatrics (stamp©) for use by healthcare staff,” J. Hum. Nutr. Diet., vol. 25, no. 4, pp. 311–318, 2012, doi: 10.1111/j.1365-277x.2012.01234.x.
42. H. Atef et al., “Development of a simple and valid nutrition screening tool for pedi-atric hospitalized patients with acute ill-ness,” F1000research, vol. 10, p. 173, 2021, doi: 10.12688/f1000research.51186.1.
43. A. Skipper, M. Ferguson, K. Thompson, V. Castellanos, and J. Porcari, “Nutrition screening tools,” J. Parenter. Enter. Nutr., vol. 36, no. 3, pp. 292–298, 2011, doi: 10.1177/0148607111414023.