Establishing Diagnostic Cut-Off Scores for the Perceived Cognitive Impairment Subscale of the Functional Assessment...

Cancer-related cognitive impairment (CRCI) negatively impacts the quality of life of non-central nervous system (non-CNS) cancer survivors. Detecting these cognitive changes remains challenging due to the lack of standardized CRCI classification and detection criteria. This study aimed to establish cut-off scores for the perceived cognitive impairment (CogPCI) subscale of the European Portuguese version of the Functional Assessment of Cancer Therapy-Cognitive Function-Version 3 (FACT-Cog-v3).

We analyzed data from 266 Portuguese-speaking non-CNS cancer survivors and performed a receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic validity of the CogPCI subscale of the FACT-Cog-v3 to detect meaningful perceived CRCI.

The CogPCI subscale demonstrated good screening performance in identifying individuals with and without clinically relevant CRCI, as indicated by a moderate-to-high area under the curve (AUC) score of 0.87. A suggested optimal cut-off score of < 51 provided good sensitivity (81.2%) and specificity (78.9%) for CogPCI to differentiate between the two groups. Over half of the participants reported significant cognitive complaints, highlighting the urgent need for standardized cognitive assessments in oncology.

This study contributes valuable insights into the early and fast detection and intervention of CRCI in Portugal. Using a brief, validated, self-report cognitive assessment tool can enhance the management of cognitive symptoms in non-CNS cancer survivors.