Cancer-related cognitive impairment in survivors of adolescent and young adult cancer: A scoping review

Objectives: Cancer-related cognitive impairments (CRCI) are common after treatment and could have importantrepercussions for adolescent and young adult (AYA) survivors diagnosed between ages 15 and 39. However, mostresearch focuses on younger or older survivors so we know relatively little about CRCI among AYA cancer survivors.Here we review the research on CRCI among survivors of AYA cancer to determine prevalence, associated factors,and ongoing impact.Methods: In December 2020 we performed a systematic search in MEDLINE, Web of Science, PsycInfo, CINAHL,EMBASE, and Cochrane Central Register of Controlled Trials to identify peer-reviewed English language articlesdescribing original research with survivors of AYA cancer having at least one outcome concerning cognition. We screened 4090 articles and 35 met eligibility criteria. Guided by the PRISMA-ScR Checklist, we extractedinformation, assessed study quality, organized articles by study design, identified factors associated with CRCI, andidentified ongoing impacts of CRCI.Results: Most studies were cross-sectional surveys and interviews with some longitudinal and neurocognitiveassessment studies, one brain imaging study, and one intervention study. Weighted mean prevalence of CRCI was38.4%. Factors associated with CRCI included older age, female gender, higher dose chemotherapy, andcomorbidities. Ongoing impacts of CRCI included impaired role functioning, financial toxicity, and unmet needs.However, the intervention study had encouraging results for improving cognition and functioning.Conclusions: This review of literature on CRCI in survivors of AYA cancer shows a need for longitudinal, imaging,and intervention studies. Digital health technology is recommended for research and intervention implementation.