The MASCC COG-IMPACT: The COSA Endorsement of a MASCC Developed Unmet Needs Assessment Tool for Cancer-Related Cognitive Impairment Impact

Cancer-related cognitive impairment (CRCI) is a common side effect of cancer reported by up to 75% of survivors. CRCI encompasses the negative changes in the functioning of cognitive processes and abilities, including concentration, speed of information processing, memory, cognitive flexibility, and decision-making, as a result of cancer, its treatments, and/or cancer-related distress. CRCI can have a significant and long-lasting impact on the lives of people affected by cancer across multiple domains, including occupational and educational functioning, the performance of daily activities, social and relationship functioning, and psychological well-being.

The World Health Organisation (WHO) Package of Interventions for Rehabilitation in Cancer has recognized cognitive functioning as a key rehabilitation target for cancer survivors. In line with this, a multitude of intervention approaches across pharmacological and non-pharmacological approaches have been developed to improve cognitive functioning for those experiencing CRCI. In addition to interventions to improve cognitive functioning, supportive care approaches designed to lessen the negative effects of CRCI on quality of life and daily functioning have also been developed [1], which include practical strategies such as the tailoring or accommodation of occupational settings to facilitate return to, and performance within, work.

There has been a range of self-report and objective assessment tools developed and validated to assess the presence and severity of CRCI using a-priori thresholds. While these tools have seen uptake in clinical and research settings to support the determination, prioritization, and assessment of interventions to improve cognitive functioning, health professionals commonly report feeling under-resourced to assess the significant unmet needs often experienced by cancer survivors that result from the impact of CRCI on their activities of daily living. Existing unmet needs assessments within oncology are typically broad in scope and do not provide the necessary information to determine unmet needs that are perceived to be a result of CRCI. Therefore, while health professionals are typically resourced with the necessary tools to assess the presence and severity of CRCI, they do not have the resources to effectively assess the unmet needs resulting from CRCI, impacting their ability to facilitate appropriate supportive care through the implementation and evaluation of tailored interventions, practical strategies, and referral. This finding placed a priority on the development of a multi-domain, purpose-built, unmet needs assessment tool for CRCI impact.