Assessment of appetite loss and related factors in older patients with cancer: validation of the cancer appetite and symptom questionnaire (CASQ) in Turkish patients

Objective: This study aimed to validate the Cancer Appetite and Symptom Questionnaire (CASQ) for Turkish older cancer patients and identify factors influencing appetite loss and related symptoms. The research question focused on whether the CASQ is a reliable tool for assessing appetite-related symptoms and determining associated risk factors in this population. Methods: A total of 240 cancer patients aged ≥70 years were recruited from a Turkish oncology clinic. Demographic, cancer-related, nutritional, functional, and psychological data were collected. Appetite was assessed using the CASQ and Simplified Nutritional Appetite Questionnaire (SNAQ). Structural validity, reliability, and diagnostic performance were evaluated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Logistic regression was performed to identify factors associated with appetite loss. Results: The CASQ demonstrated high reliability and validity, with a Cronbach’s alpha of 0.971 and Kaiser–Meyer–Olkin (KMO) of 0.907. EFA and CFA supported a single-factor structure. A CASQ cutoff score of 32 showed high diagnostic accuracy (AUC: 0.971) with 88.9% sensitivity. Appetite loss was reported in 53.7% of patients and was significantly associated with stage IV cancer (OR: 10.112, p <.001), chemotherapy (OR: 2.960, p =.016), severe pain (OR: 3.089, p =.003), malnutrition (OR: 4.459, p =.033), polypharmacy (OR: 2.213, p =.040), and poor performance status (OR: 5.245, p =.017). Conclusions: The CASQ is a validated, reliable tool for assessing appetite-related symptoms in Turkish older cancer patients. Findings underscore the need for integrated nutritional and psychological care. Future research should develop targeted interventions to mitigate appetite loss and its impact on quality of life in this population. © 2025 Informa UK Limited, trading as Taylor & Francis Group.