Background: Malnutrition is a significant comorbidity in pediatric oncology and is linked to increased treatment toxicity, infection risk, treatment interruptions, and poorer survival. In low- and middle-income countries such as India, baseline undernutrition may further worsen outcomes in children with cancer. However, data from large public hospital settings remain limited. This study aimed to determine the prevalence of malnutrition at diagnosis among pediatric cancer patients treated in government hospitals in Delhi. 

Methods: This retrospective observational study included 1,042 pediatric cancer patients who presented between April 2018 and April 2024 at two government hospitals in Delhi. Demographic details, cancer type, and baseline anthropometric measurements were collected from medical records. Nutritional status at diagnosis was assessed using standard anthropometric criteria. The prevalence of malnutrition was calculated and analyzed across age groups and malignancy types. 

Results: Hematological malignancies constituted over 80% of cases, reflecting common pediatric cancer patterns. Overall, 39.7% (414/1,042) of children were malnourished at diagnosis, indicating that nearly two in five patients began treatment with compromised nutritional status. A higher prevalence of malnutrition was observed in older children. Differences were also noted between hematological and non-hematological cancers, suggesting potential variation in nutritional vulnerability across disease types. 

Conclusion: A substantial proportion of pediatric cancer patients in public hospitals present with malnutrition at diagnosis. Routine nutritional screening and early dietary intervention should be integrated into pediatric oncology care to improve treatment tolerance and clinical outcomes. Prospective studies are required to assess changes in nutritional status during therapy and evaluate the impact of structured nutritional support programs.  

Haresh Gupta is a senior public health professional with over 25 years of experience in cancer care, hospital administration, clinical services, and large-scale development programs. He holds an MBA in Health Care Administration from the Faculty of Management Studies, University of Delhi, along with a Post Graduate Diploma in Health & Hospital Management and a degree in Ayurvedic Medicine and Surgery. He currently serves as Chief Program Officer – Medical and Research at Cankids Kidscan, leading pan-India initiatives to strengthen childhood cancer care. His work focuses on early diagnosis, comprehensive treatment support, nutrition, treatment adherence, survivorship, and health system strengthening across tertiary and district-level facilities. His research interests include Pediatric oncology service delivery models, cancer epidemiology, public health nutrition, and scalable interventions to reduce disparities in childhood cancer outcomes.