Quality statement 1: Nutritional status

Quality statement

People with cancer of the upper aerodigestive tract have their nutritional status, including the need for a prophylactic tube, assessed at diagnosis.

Rationale

Many people with cancer of the upper aerodigestive tract lose a lot of weight as a result of the disease and its treatment; they often have difficulty eating. Assessing their nutritional status, including their need for a prophylactic tube, at the time of diagnosis will help to ensure adequate nutrition before, during and after treatment. This in turn will maximise the chances of people with cancer of the upper aerodigestive tract completing curative treatment.

Quality measures

Structure

Evidence of local arrangements and written clinical protocols to ensure that people with cancer of the upper aerodigestive tract have their nutritional status, including the need for a prophylactic tube, assessed at diagnosis.

Data source: Local data collection and HANA (Head and Neck Cancer National Audit), Saving Faces.

Process

Proportion of people with cancer of the upper aerodigestive tract who have their nutritional status, including the need for a prophylactic tube, assessed at diagnosis.

Numerator – the number in the denominator who have their nutritional status, including the need for a prophylactic tube, assessed at diagnosis.

Denominator – the number of people diagnosed with cancer of the upper aerodigestive tract.

Data source: Local data collection and HANA (Head and Neck Cancer National Audit), Saving Faces.

Outcome

Nutritional status of people with cancer of the upper aerodigestive tract.

Data source: Local data collection, for example, body mass index (BMI) levels and percentage weight loss, and HANA (Head and Neck Cancer National Audit), Saving Faces.

What the quality statement means for different audiences

Service providers (head and neck cancer secondary and tertiary care services) have systems in place to ensure that their teams assess nutritional status, including the need for a prophylactic tube, when cancer of the upper aerodigestive tract is diagnosed.

Healthcare professionals (members of head and neck cancer multidisciplinary teams) assess nutritional status, including the need for a prophylactic tube, when they diagnose cancer of the upper aerodigestive tract.

Commissioners (NHS England) ensure that they commission services which have systems in place to assess nutritional status, including the need for a prophylactic tube, when cancer of the upper aerodigestive tract is diagnosed.

People with cancer of the upper aerodigestive tract (the mouth, throat, voice box or sinuses) have an assessment when their condition is diagnosed to check their levels of nutrition and decide whether they need or might need feeding through a tube. Tube feeding can ensure that people who are finding it difficult to eat or drink get enough nutrients.

Source guidance

Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over (2016) NICE guideline NG36, recommendation 1.8.1

Definitions of terms used in this quality statement

Cancer of the upper aerodigestive tract

This encompasses cancers arising at different sites in the airways of the head and neck. These include cancers of the oral cavity, oropharynx, nasopharynx, hypopharynx, larynx and nasal sinuses.

[NICE's guideline on cancer of the upper aerodigestive tract, full guideline glossary, appendix E]

Nutritional status

This is a person's level of nutrition and includes weight loss, high or low BMI and their ability to meet estimated nutritional needs.

[NICE's guideline on cancer of the upper aerodigestive tract, recommendation 1.8.1]