Are Nutritional Interventions Worthwhile in Cancer Patients? A Systematic Review on Economic Evaluation

Abstract

Purpose: Malnutrition in cancer patients may stem from both tumor progression and treatment regimens. Nutritional interventions have shown potential for enhancing treatment efficacy and overall quality of life, but their cost-effectiveness requires exploration. Accordingly, this study systematically investigated research on economic evaluations of nutritional interventions implemented as either preventive or therapeutic strategies in cancer patients.

Methods: PubMed and Scopus databases were searched from inception to September 9, 2025. Following study selection and data extraction, the reporting quality of included studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, while risk of bias was assessed using the ECOBIAS checklist.

Results: Eight studies, published between 1989 and 2022, primarily focused on gastrointestinal cancers and were conducted in high-income countries. Most of these investigations (6 out of 8) performed cost-utility analyses. Four indicated that combining oral supplements or parenteral nutrition with nutritional counseling was more cost-effective, although these studies differed in terms of time horizons, types of interventions evaluated, and types of comparators used. Most of the studies adhered to the CHEERS standards, but no reported on characterizing heterogeneity, and none discussed approaches to stakeholder involvement in study design. Based on the ECOBIAS framework, the three most frequently encountered risks of bias were limited sensitivity analysis bias, bias related to quality-of-life weights, and limited scope bias.

Conclusion: The findings offer physicians valuable guidance for optimizing treatments and potentially support policy decision-making.

Keywords: cancer; cost-effectiveness; economic evaluation; nutritional intervention; systematic review.

Figure 1

PRISMA flow of study selection process.