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Meta-Analysis
. 2024 Mar 5;32(4):209.
doi: 10.1007/s00520-024-08402-9.

Prevalence and assessment tools of cancer-related cognitive impairment in lung cancer survivors: a systematic review and proportional meta-analysis

Mu-Hsing Ho  1 , Tsz Wei So  2 , Chun Lun Fan  3 , Yiu Tak Chung  4 , Chia-Chin Lin  5
Affiliations
Meta-Analysis

Prevalence and assessment tools of cancer-related cognitive impairment in lung cancer survivors: a systematic review and proportional meta-analysis

Mu-Hsing Ho et al. Support Care Cancer. .

Abstract

Purpose: Cancer-related cognitive impairment (CRCI) is a significant risk factor influencing the quality of life in lung cancer survivors. No absolute assessment tool has been confirmed to assess CRCI in lung cancer survivors. This review was undertaken to pool the overall prevalence of CRCI and to summarize the assessment tools in assessing CRCI among lung cancer survivors.

Methods: PubMed, Cochrane Library, Embase, CINAHL, and CNKI were searched to retrieve articles reported CRCI prevalence. Summary prevalence estimates were pooled using a random effects model, along with corresponding 95% prediction intervals (PIs). The Freeman-Tukey double arcsine transformation of proportions was incorporated in the analysis. Additionally, subgroup analysis, meta-regression, and leave-one-out analysis were performed.

Results: A total of 12 studies, involving 1934 survivors, were included in the review. All of these studies were found to have a low risk of bias in terms of their methodological quality. Four studies (33.3%) utilized the International Cognition and Cancer Task Force (ICCTF) criteria to identify CRCI through neuropsychological tests. The pooled prevalence rate of CRCI was found to be 26% (95% PI, 16-37%), I2 = 95.97%. The region in which the studies were conducted was identified as a significant factor contributing to this heterogeneity (p = 0.013). No indication of small-study effects was found (Egger's test: p = 0.9191).

Conclusion: This review provides an overview of CRCI prevalence and assessment tools in lung cancer survivors. The findings can serve as epidemiological evidence to enhance clinicians' and researchers' understanding of early detection and assessment.

Keywords: Cancer nursing; Cancer-related cognitive impairment; Meta-analysis; Prevalence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram detailing the selection process of the included studies
Fig. 2
Fig. 2
The forest plot of the overall pooled prevalence and study conducted in Asia, Europe, and North America reported estimates of cancer-related cognitive impairment from a random effects model
Fig. 3
Fig. 3
Bubble plot for region to display the result of meta-regression. Note. Region was found to be a significant factor contributing to heterogeneity (p = 0.017). CRCI, cancer-related cognitive impairment
Fig. 4
Fig. 4
Leave-one-out analysis to identify the outlier and its impact. Note. Omitting study by Bartels et al. (2021) causes the overall prevalence of CRCI to decrease by 23% (overall prevalence of 12 studies was 26%). CRCI, cancer-related cognitive impairment
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