Cancer‐related cognitive impairment in survivors of adolescent and young adult non‐central nervous system cancer: A scoping review

Abstract

Objectives Cancer‐related cognitive impairments (CRCI) are common after treatment and can have important impacts on the lives of adolescent and young adult (AYA) cancer survivors—those cancer survivors diagnosed between ages 15 and 39. However, most research focuses on survivors diagnosed under age 15 or over age 39 so we know relatively little about CRCI among AYA survivors of non‐central nervous system (CNS) cancers. Here we review the research on CRCI among AYA survivors of non‐CNS cancers to determine prevalence, associated factors, and impact on survivors' lives as well as implications for future research. Methods In November 2021 we performed a systematic search of the literature in MEDLINE, Web of Science, PsycInfo, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials to identify peer‐reviewed English language articles describing original research with at least one cognitive outcome and conducted with AYA survivors of non‐CNS cancer diagnosed as AYAs. We screened 6003 articles and 21 met eligibility criteria. Guided by the PRISMA‐ScR Checklist, we extracted study information to meet review objectives. Results Most studies employed cross‐sectional surveys or interviews, though some employed longitudinal methods, neurocognitive assessments, or brain imaging. From the subset of articles that reported a prevalence we calculated a weighted mean prevalence of 25.75% and weighted median prevalence of 27.8%. The factors associated with CRCI included female gender, higher dose chemotherapy, and comorbidities. CRCI impacted the lives of AYA survivors through impaired role functioning, financial toxicity, and unmet needs. Conclusions CRCI is highly prevalent among non‐CNS cancer survivors diagnosed as AYAs and impacts quality of life and role functioning. This review suggests a need for further longitudinal, imaging, and mixed methods research and provision of resources to help achieve better quality of life and educational and occupational attainment during what is potentially a decades‐long survivorship period. However, although interventions might improve cognition and functioning, the review identified only one pilot study. Digital interventions may be a practical and effective option for this age group, but they have yet to be adequately investigated.

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“…The most recent review by Vizer et al (2022) includes studies about the cognitive impairment faced by people under 39 years of age with cancer located outside the central nervous system (CNS). The review found that CRCI affects approximately 26% of subjects of this age [ 23 ]. For all of the reasons cited above, patient age was not an inclusion criterion for our own study.…”

“…Vizer et al (2022), in their systematic review, highlight that of the 21 articles included in the review, only one was a study using an intervention, even though various types of activities can improve cognitive function. Interventions using digital methods, which can be a practical and effective option, were also not addressed [ 23 ]. The need for cognitive rehabilitation was noted by Dos Santos et al [ 11 ], who demonstrated that training using computer-based methods led by a neuropsychologist is more effective than mental tasks performed at home or no mental exercises.…”

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“…As a result, this review article may be as specific as possible to the assessment of chemotherapy-induced cognitive dysfunction. The scoping review by Vizer et al (2022) should be referenced since it focused on studies on the Adolescent and Young Adult (AYA) generation, which was not the focus of the present review.…”