Objective: This study aimed to estimate the prevalence, severity, and multidomain impact of cancer cachexia among Pakistani breast cancer patients, using the validated Mini-CASCO scoring system. Methods: We conducted an observational, cross-sectional study from February to December 2024 at Fauji Foundation Hospital (FFH), Rawalpindi. Eligible participants were female patients aged 18 years or older, with stage I–III breast cancer, receiving chemotherapy. Cachexia was assessed using the Mini-CASCO, which encompasses body composition, inflammation, anorexia, physical performance, and quality of life. Demographic, anthropometric, biochemical, and validated patient-reported outcomes were collected. Group differences between cachectic and non-cachectic patients were analyzed using the chi-square (χ²) test, with statistical significance set at p < 0.05. Results: Of 134 participants (mean age: 45.2 ± 8.3 years), the prevalence of cachexia was 61.9% (95% CI: 53.4–70.0). The mean Mini-CASCO score was 45.7 ± 9.3 (95% CI: 43.7–47.8), indicating moderate cachexia. The severity distribution was 16.9% mild, 49.4% moderate, and 33.7% severe; no terminal cases were detected. Body weight and composition (12.7 ± 4.3) and anorexia (9.2 ± 2.6) were the most impaired domains. Compared with non-cachectic patients, those with cachexia had significantly greater inflammation (11.2 vs. 7.4, p < 0.001), anorexia (10.9 vs. 6.8, p < 0.001), and poorer quality of life (6.2 vs. 4.7, p < 0.001). Conclusion: More than six in ten patients exhibited cachexia a rate substantially higher than global estimates highlighting its neglected burden in low- and middle-income country (LMIC) oncology settings. Early, structured assessment using the Mini-CASCO, along with the integration of multimodal nutritional and supportive interventions, is urgently needed to reduce preventable morbidity and mortality. Future multicenter, longitudinal studies are essential to guide evidence-based cachexia management in LMICs.
Maria, R. , Samad, F. Abdus , Khalid, A. and Sidhu, S. Masood (2026). Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System. Asian Pacific Journal of Cancer Prevention, 27(5), 1787-1793. doi: 10.31557/APJCP.2026.27.5.1787
MLA
Maria, R. , , Samad, F. Abdus, , Khalid, A. , and Sidhu, S. Masood. "Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System", Asian Pacific Journal of Cancer Prevention, 27, 5, 2026, 1787-1793. doi: 10.31557/APJCP.2026.27.5.1787
HARVARD
Maria, R., Samad, F. Abdus, Khalid, A., Sidhu, S. Masood (2026). 'Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System', Asian Pacific Journal of Cancer Prevention, 27(5), pp. 1787-1793. doi: 10.31557/APJCP.2026.27.5.1787
CHICAGO
R. Maria , F. Abdus Samad , A. Khalid and S. Masood Sidhu, "Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System," Asian Pacific Journal of Cancer Prevention, 27 5 (2026): 1787-1793, doi: 10.31557/APJCP.2026.27.5.1787
VANCOUVER
Maria, R., Samad, F. Abdus, Khalid, A., Sidhu, S. Masood Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System. Asian Pacific Journal of Cancer Prevention, 2026; 27(5): 1787-1793. doi: 10.31557/APJCP.2026.27.5.1787
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