ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Screening for cognitive impairment in routine clinical oncology practice: a pilot study using patient-reported outcome measures and online cognitive testing in melanoma and breast cancer patients.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis pilot study aimed to identify patients with cognitive impairment by a stepped-care use of patient-reported outcome measures (PROMs) and complementary online cognitive tests implemented in routine clinical practice.
methodsSelf-reported cognitive functioning was measured in breast cancer or melanoma patients, 6 months after start of treatment, with two items of the EORTC QLQ-C30. Scores below a predefined threshold of 75 indicated clinically relevant cognitive impairment. Subsequent objective cognitive functioning was assessed with an online test battery, consisting of seven tests. Impaired cognitive functioning was defined as a z score of ≤ - 1.5 on 2 or more tests, a z score of ≤ - 2 on one single test, or both. Descriptive statistics were used to analyze the prevalence of impairment.
resultsIn total, 261 patients completed PROMs 6 months after start treatment; 38/154 (25%) melanoma and 43/107 (40%) breast cancer patients reported clinically relevant self-reported cognitive impairment. Of them, 12/38 (32%) melanoma and 15/43 (35%) breast cancer patients opted for complementary online cognitive testing. Of those completing formal tests, objectively measured cognitive impairment was identified in 4/12 (33%) melanoma and 10/15 (67%) breast cancer patients.
conclusionA significant number of patients report cognitive problems 6 months after starting treatment. Only onethird was able and/or expressed the need for further diagnostics. Among those who were formally tested, 33-67% had cognitive impairment, which is 3-9% of the total group that completed PROMs in routine care. IMPLICATIONS FOR CANCER SURVIVORS: This pilot study suggests that a stepped care pathway for cognitive problems is relevant and also mangable in terms of clinical care.
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