{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:51:13Z","timestamp":1791568273524,"version":"4.3.4"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"abstract":"<jats:p>Cancer-related cognitive impairment (CRCI) is common in patients with non-central nervous system malignancies, but its identification remains difficult because symptoms are heterogeneous, may predate treatment, and are not captured by a single measure. This narrative review synthesizes evidence on epidemiology, clinical phenotype, risk factors, neuropsychological assessment, neuroimaging, and practical pathways for identifying CRCI in oncology care. Emerging literature highlights subjective-objective discordance and self-awareness as clinically relevant dimensions. Prevalence varies by timing and method, with higher estimates from self-report than from screening tools or formal batteries. Identification is more reliable when assessment combines patient-reported outcomes (PRO), brief objective screening, and focused neuropsychological testing within baseline vulnerability and concurrent symptom burden. Older age, lower cognitive reserve, pretreatment cognitive impairment, systemic illness, fatigue, insomnia, mood symptoms, pain, and medication effects are major modifiers. In clinical settings, neuroimaging is useful primarily for differential diagnosis: conventional brain MRI excludes competing neurologic disorders, while volumetric MRI, diffusion imaging, resting-state functional MRI, and [18F]FDG-PET currently provide group-level evidence rather than individual diagnostic signatures. At present, CRCI is best identified through a stepwise clinical strategy integrating PRO evaluation, objective testing, risk profiling, and selective imaging, considering individual patient modifiers rather than a single diagnostic test.<\/jats:p>","DOI":"10.1177\/03008916261489141","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:42:41Z","timestamp":1791438161000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond chemobrain: A stepwise approach to identifying cognitive impairment in non-CNS cancer survivors"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7427-4591","authenticated-orcid":false,"given":"Martina","family":"Pulze","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"},{"name":"Medical Physics Unit, ASST Lodi, Lodi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Losa","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Buonopane","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Al\u00ec","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Caneva","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"},{"name":"IRCCS Azienda Ospedaliera Metropolitana Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4740-1982","authenticated-orcid":false,"given":"Matteo","family":"Pardini","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy"},{"name":"IRCCS Azienda Ospedaliera Metropolitana Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70294-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz410"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-05682-1"},{"key":"e_1_3_2_5_2","first-page":"209","article-title":"Prevalence and assessment tools of cancer-related cognitive impairment in lung cancer survivors: a systematic review and proportional meta-analysis","volume":"32","author":"Ho MH","year":"2024","unstructured":"Ho MH, So TW, Fan CL, et al. Prevalence and assessment tools of cancer-related cognitive impairment in lung cancer survivors: a systematic review and proportional meta-analysis. Support Care Cancer 2024; 32: 209.","journal-title":"Support Care Cancer"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-071726"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2025.102235"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx285"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-023-01436-8"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP-24-00953"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2023.1063674"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2012.05.002"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.011"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41687-018-0071-4"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab027"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-023-06968-2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5928"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-014-1995-y"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-025-08066-1"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_3_2_22_2","article-title":"Investigation of a mobile, digital application to objectively assess cognitive function in cancer survivors","volume":"53","author":"Myers JS","year":"2026","unstructured":"Myers JS, Ramakrishnan S, Holt LS, et al. Investigation of a mobile, digital application to objectively assess cognitive function in cancer survivors. Oncol Nurs Forum 2026; 53: 1\u201318.","journal-title":"Oncol Nurs Forum"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-015-2428-2"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02363"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6185"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.71130"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1662935"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20272"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.5826"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22221"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.3553"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70207-9"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12642"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.11.136"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30320"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2016.04.009"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.055585"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.12.001"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-024-00797-2"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-023-00781-7"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2012.05.007"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.8571"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-016-9665-8"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-020-01094-z"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-021-01096-5"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1214551110"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2012.07.009"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.4333"},{"key":"e_1_3_2_49_2","article-title":"Advances in neuroimaging in cancer-related cognitive impairment","volume":"20","author":"Li J","year":"2026","unstructured":"Li J, Cui F, Yang Y, et al. Advances in neuroimaging in cancer-related cognitive impairment. Front Hum Neurosci 2026; 20: 1738024.","journal-title":"Front Hum Neurosci"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12891"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514546791"}],"container-title":["Tumori Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03008916261489141","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03008916261489141","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03008916261489141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:59:18Z","timestamp":1791565158000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03008916261489141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":50,"alternative-id":["10.1177\/03008916261489141"],"URL":"https:\/\/doi.org\/10.1177\/03008916261489141","relation":{},"ISSN":["0300-8916","2038-2529"],"issn-type":[{"value":"0300-8916","type":"print"},{"value":"2038-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"03008916261489141"}}