Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Diagnostic Performance of Current Screening Tools in Identifying Low Muscle Mass in Adults with Cancer: A Scoping Review (146187)

Natalie LX Tan 1 , Annie R Curtis 1 , Brenton J Baguley 1 2 , Tanita Botha 3 , Nicole Kiss 1 2
  1. Deakin Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VICTORIA, Australia
  2. Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, VICTORIA, Australia
  3. Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VICTORIA, Australia

Aims: Cancer-related low muscle mass (LMM) currently lacks a validated screening tool. Since LMM is a component of malnutrition and sarcopenia, screening tools for these conditions may be capable of identifying LMM. However, the diagnostic performance of these tools has not been comprehensively examined. This scoping review examined the ability (criterion validity and reliability) of current screening tools to identify LMM in adults with cancer.

Methods: A systematic search was conducted across CINHAL Complete, Embase via EBSCOHost and MEDLINE Complete. Eligible studies assessed the ability of a screening tool to identify LMM, used a technical approach for muscle mass assessment as the reference standard, and included adults with any cancer diagnosis who were undergoing any cancer treatment.

Results: The search identified 15,811 studies, of which four met the eligibility criteria. Five screening tools were identified: Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), Nutritional Risk Index (NRI), Strength, Assistance in walking, Rising from a chair, Climbing stairs and Falls (SARC-F), and SARC-F with calf circumference (SARC-CalF). All four studies used skeletal muscle index from computed tomography (CT) images as the reference standard for muscle mass assessment. The malnutrition screening tools demonstrated substantial variability in diagnostic performance, with sensitivity (17.2-95.1%) and specificity (13.5-83.2%) ranging from poor to good, and showed poor overall discriminative performance (AUROC, ≤0.6). Whilst the sarcopenia screening tools reported higher specificity (75.2-89.3%), they still reported poor sensitivity (15.2-59.5%) and low AUROC (0.56-0.74). Only one study evaluated reliability, reporting no significant agreement between MST and CT-defined LMM (k=0.071, p=0.570).

Conclusion: Current screening tools for malnutrition and sarcopenia are unable to accurately and reliably identify LMM in people with cancer. A screening tool designed specifically for LMM is required to complement current screening practices and facilitate improved recognition and management of cancer-related muscle loss.