Neuropsychological assessment in non-central nervous system cancer patients: a systematic review of cognitive screening and assessment within oncology practice

Early cancer detection and innovative treatments have prolonged the lifespan of cancer patients, leading to long-term consequences, including cancer-related cognitive impairment (CRCI). In 2011, the International Cancer and Cognition Task Force (ICCTF) established guidelines for neuropsychological assessment, however many neuropsychological tests lack validity for oncological patients. This systematic review aims to identify and summarise the most commonly used neuropsychological tests for cognitive screening and assessment in non-CNS cancer patients within research contexts. A search of electronic databases (PUBMED, EMBASE, and SCOPUS) included 1) research articles using 2) neuropsychological tests 3) on non-CNS cancer patients, 4) aged between 18 and 80 years old, 5) published in the English 6) from January 2011 to October 2023. Quality assessment was assessed following the MMAT Guidelines. Eligibility criteria were met by 178 studies which adopted 151 different neuropsychological tests. The most widely used screening test was the Mini-Mental State Examination (N=41). Among the main cognitive domains analyzed, the Hopkins Verbal Learning Test-Revised (N=61) was the most commonly used to assess memory. The Controlled Oral Word Association Test (N=24) was primarily utilised for language assessment and the Trail Making Test-part A (TMT-A) (N=37) was the most frequently used to assess the attention domain. Moreover, executive functions were predominantly evaluated using the TMT-B (N=45). Among the included studies, only 42 adhered to the ICCTF guidelines. Despite the available guidelines, the wide variability of the utilised tests undermines the generalisability of results. These findings underscore the necessity of developing and implementing assessment and screening tools that are specifically tailored to cancer patients.