Food insecurity among people with cancer: Nutritional needs as an essential component of care

Authors: RABER, MARGARET - Children'S Nutrition Research Center (CNRC); JACKSON, ANN - Center For Food Equity In Medicine; BASEN-ENGQUIST, KAREN - Md Anderson Cancer Center; BRADLEY, CATHY - Colorado School Of Public Health; CHAMBERS, SHONTA - Patient Advocate Foundation; GANY, FRANCESCA - Sloan Kettering Cancer Center; HALBERT, CHANITA - University Of Southern California; LINDAU, STACY - University Of Chicago; PÉREZ-ESCAMILLA, RAFAEL - Yale University; SELIGMAN, HILARY - University Of California San Francisco (UCSF)

Submitted to: Journal of the National Cancer Institute
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/27/2022
Publication Date: 9/21/2022
Citation: Raber, M., Jackson, A., Basen-Engquist, K., Bradley, C., Chambers, S., Gany, F.M., Halbert, C.H., Lindau, S.T., Perez-Escamilla, R., Seligman, H. 2022. Food insecurity among people with cancer: Nutritional needs as an essential component of care. Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djac135.
DOI: https://doi.org/10.1093/jnci/djac135

Interpretive Summary: A cancer diagnosis can disrupt work life and family finances, leading some patients to disregard the importance of essentials such as food. Currently, the percentage of cancer patients experiencing food insecurity is estimated to range between 17% and 55%. Each phase of a patient's cancer journey requires an extensive network of support to guarantee that the patient's nutritional needs are being met. We reviewed the issue of food insecurity in cancer care, described current efforts to reduce food insecurity among patients, and explored potential ways to address food insecurity based on the National Academies of Sciences, Engineering, and Medicine 5 A's Social Care Framework including: awareness, adjustment, assistance, alignment, and advocacy. We include a call to action for comprehensive cancer centers to implement achievable, effective strategies to address food insecurity including standardized food insecurity screening, workflows to link patients to community or hospital-based food programs, and advocacy for patients through policy action.

Technical Abstract: A cancer diagnosis can upend work and family life, leading patients to reallocate resources away from essentials such as food. Estimates of the percentage of people navigating a cancer diagnosis and food insecurity range between 17% and 55% of the cancer patient population. The complexity of addressing food insecurity among those diagnosed with cancer during different phases of treatment is multifactorial and often requires an extensive network of support throughout each phase. This commentary explores the issue of food insecurity in the context of cancer care, explores current mitigation efforts, and offers a call to action to create a path for food insecurity mitigation in the context of cancer. Three programs that address food insecurity among those with cancer at various stages of care are highlighted, drawing attention to current impact and actionable recommendations to make programs like these scalable and sustainable. Recommendations are grounded in the National Academies of Sciences, Engineering, and Medicine social care framework through 5 essential domain areas: awareness, adjustment, assistance, alignment, and advocacy. This commentary seeks to highlight opportunities for the optimization of cancer care and reframe food access as an essential part of treatment and long-term care plans.