The Association Between Food Insecurity and Health Outcomes Among Cancer Survivors: A Systematic Review
Usa Khemthong, Amber Kolesar, Saengrawee Thanthong, Pratchaya Wannachat, Jantima Phongchueakaeo, Piyapat UdomsukBackground:
Food insecurity is associated with poorer health status and reduced access to cancer treatments. This systematic review aimed to examine the association of food insecurity with health outcomes and treatment complications in cancer survivors.
Methods:
A comprehensive search was conducted across 5 electronic databases through July 5, 2025: PubMed, CINAHL, MEDLINE, Scopus, and PsycINFO. Studies were included if they met the following criteria: (a) a primary study examining food insecurity in cancer survivors aged ≥18; (b) examined outcomes related to health-related quality of life, mental health status, medication/treatment adherence, postoperative complications, or mortality rate; and (c) reported results in English. Studies were excluded if they were review articles, qualitative studies, or editorials/conference papers. The Joanna Briggs Institute critical appraisal tools were used to assess the risks of bias.
Results:
Twenty-one studies, identified from 878 references, met the inclusion criteria. Thirteen studies reported status issues, including physical, behavioral, and mental health problems, as well as quality-of-life outcomes. Few studies indicated that cancer survivors with food insecurity had significantly higher length of stay, 90-day readmission rates, or a greater likelihood of postoperative ileus. Evidence from 5 studies indicated that food insecurity was linked to a higher risk of mortality. Two studies reported associations between food insecurity and treatment adherence, specifically prescription medication use and the postponement of follow-up care.
Conclusion:
Nurses should regularly screen cancer patients for food insecurity to facilitate prompt referral to interdisciplinary support. Future research should evaluate interventions and their effects on clinical outcomes and treatment adherence.
PROSPERO Protocol Registration:
CRD420251083222.