(LB04-07-26) Association Between Food Insecurity and Malnutrition Risk Among Cancer Survivors

Objectives: Food insecurity is a critical non-medical determinant of health associated with poorer nutritional status and adverse outcomes among cancer survivors, yet its relationship with validated measures of malnutrition risk remains poorly characterized. This study aims to evaluate the association between food insecurity and the risk of malnutrition in a diverse cohort of cancer survivors.

Methods: We conducted a retrospective analysis of patients seen at Sylvester Comprehensive Cancer Center between October 2019 and February 2026 who completed patient-reported outcomes (PROs) and supportive care needs assessments paired with their ambulatory oncology visits. Food insecurity was measured as self-reported difficulty accessing food. Malnutrition risk was categorized as high (NUTRISCORE ≥5) or low (≤4). Demographic characteristics were compared between food-secure and food-insecure groups. A chi-square test was used to assess the association between food insecurity and nutritional risk.

Results: A total of 23,737 cancer survivors were assessed, of whom 1,873 (7.9%) reported experiencing food insecurity. Patients experiencing food insecurity were younger (mean age 61.6 vs. 63.9 years, p< 0.001), more likely to identify as Black (16% vs. 9%, p< 0.001), and more frequently unpartnered (48% vs. 34%, p< 0.001) compared to food-secure patients. Food insecurity was significantly associated with a higher risk of malnutrition. Participants experiencing food insecurity had a higher prevalence of high malnutrition risk (NUTRISCORE ≥5) than those without food insecurity (31% vs. 13%, p< 0.001).

Conclusions: Food insecurity was associated with greater malnutrition risk among cancer survivors and may disproportionately affect vulnerable populations. These findings highlight the importance of integrating food insecurity screening into routine supportive care and oncology workflows. Addressing food access as part of integrative oncology care may help reduce disparities, improve nutritional status, and enhance overall patient outcomes during a critical time. Future efforts should focus on implementing targeted interventions and resource navigation strategies to support at-risk populations.

Funding Sources: This study was funded in part by grant P30 CA240139 from the National Cancer Institute.