DYSPHAGIA IN OLDER ADULTS WITH ADVANCED CANCER: A PILOT CROSS-SECTIONAL STUDY

N. Nowak¹, D. Myrcik², G. Varrassi³, U. Michalik-Marcinkowska⁴, K. Walkiewicz², M. Muc-Wierzgoń², M. Syrkiewicz-Świtała⁵ | ¹Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland; ²Department of Propaedeutics of Internal Diseases and Emergency Medicine, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland; ³Fondazione Paolo Procacci, Rome, Italy; ⁴Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Poland; ⁵Department of Health Economics and Health Management, Medical University of Silesia in Katowice, Bytom, Poland

Abstract

Background and Aims. Dysphagia is a clinically important but frequently underrecognized symptom in older adults with advanced cancer. In palliative oncology, its prevalence approaches 30%, with higher rates in patients with head, neck, and upper gastrointestinal malignancies. Screening may therefore identify patients at risk of nutritional deterioration and impaired supportive care. The aim was to assess dysphagia prevalence and evaluate its association with tumor location, functional status, weight loss, and swallowing-related symptoms.
Methods. A pilot cross-sectional study included 80 adults aged ≥65 years with advanced cancer. Dysphagia was screened using the Eating Assessment Tool-10 (EAT-10), with a score ≥3 considered positive. Variables included age, sex, tumor location, ECOG status, weight loss, and specific symptoms. Fisher’s exact test was used for analyses.
Results. Positive dysphagia screening was identified in 24/80 patients (30.0%). Dysphagia was significantly more frequent in patients with swallow-related or upper gastrointestinal tumors than in other malignancies (54.5% vs. 20.7%, p=0.006). It was also more common in those with ECOG 3–4 than ECOG 0–2 (53.3% vs 16.0%, p<0.001) and those with weight loss (48.6% vs 15.6%, p=0.003). Strong associations were observed for cough during swallowing (81.3% vs. 17.2%, p<0.001), odynophagia (78.6% vs. 19.7%, p<0.001), and texture modification (86.4% vs. 8.6%, p<0.001). Differences by age and sex were not significant.
Conclusions. Dysphagia affects nearly one-third of older adults with advanced cancer and is strongly associated with tumor location, poor performance status, weight loss, and swallowing-related symptoms. Routine screening with tools like EAT-10 may facilitate earlier identification and improve supportive care.