成人癌症患者的心理社会健康服务应包括对认知症状和症状群的支持。在寻求心理社会支持的门诊成人癌症患者中，描述认知症状的频率和严重程度，并确定与中度至重度认知症状相关的人口和临床风险因素。这项横断面研究分析了 2013 年 1 月 1 日至 2019 年 12 月 31 日期间在加拿大多伦多玛格丽特公主癌症中心进行的常规患者报告症状筛查的数据。参与者为门诊成人（年龄≥18 岁）患有多种癌症诊断并表示有兴趣从医疗保健团队成员那里获得心理社会支持的人。数据分析于 2020 年 4 月至 2024 年 6 月进行。参与者自评的认知症状的存在和严重程度针对 12 种癌症类型进行了表征：脑或中枢神经系统 (CNS)、乳腺癌、胃肠道、头颈癌、妇科癌症、甲状腺癌、肺癌和支气管癌、肉瘤、泌尿生殖系统癌、黑色素瘤、血液癌和所有其他癌症。使用多变量逻辑回归来探讨人口统计学、临床和症状因素与中度至重度认知症状之间的关联。在 5078 名受访者样本中（2820 名女性 [55.5%]；调查时的平均 [SD] 年龄为 56.0 [ 14.1] 年），3480 人（68.5%）报告了任何严重程度的认知症状，从肉瘤中的 59.5% 到脑或中枢神经系统癌症中的 86.5%。 1544例患者（30.4%）报告有中度至重度认知症状，其中脑或中枢神经系统患者占51.3%，乳腺患者占37.0%，甲状腺患者占36.2%，黑色素瘤患者占30.9%，头颈部患者占29.6%，胃肠道癌为28.3%，血液癌为28.2%，妇科癌为28.1%，肺癌和支气管癌为24.9%，肉瘤为24.9%，泌尿生殖系统癌为21.0%，所有其他癌症为26.8%。在整个样本中，中度至重度认知症状与累及 CNS 的复发或进展相关（比值比 [OR]，2.62；95% CI，1.80-3.81）、抑郁症（OR，1.92；95% CI，1.59-2.31） ）、疲倦（OR，1.82；95% CI，1.52-2.19）、嗜睡（OR，1.64；95% CI，1.39-1.93）、焦虑（OR，1.57；95% CI，1.30-1.89）、呼吸短促（OR，1.38；95% CI，1.16-1.61），女性（OR，1.33；95% CI，1.14-1.56），接受一线化疗（OR，1.22；95% CI，1.05-1.41），以及诊断时存在转移性疾病（OR，0.74；95% CI，0.61-0.89）。在各种癌症类型中，疲劳和抑郁始终与中度至重度认知症状相关。这项横断面研究发现，多种癌症类型的患者经常报告认知症状；认知症状的严重程度越高，症状负担越高。研究结果可用于为肿瘤门诊中获得认知筛查、评估和支持性护理的决策提供信息。

Psychosocial health services for adults with cancer should include support for cognitive symptoms and symptom clusters.To characterize the frequency and severity of cognitive symptoms and to identify demographic and clinical risk factors associated with moderate to severe cognitive symptoms among outpatient adults with cancer seeking psychosocial support.This cross-sectional study analyzed data from routine patient-reported symptom screening during clinic appointments at the Princess Margaret Cancer Centre in Toronto, Canada, between January 1, 2013, and December 31, 2019. Participants were outpatient adults (aged ≥18 years) with diverse cancer diagnoses who endorsed interest in receiving psychosocial support from a health care team member. Data analysis was performed from April 2020 to June 2024.The presence and severity of cognitive symptoms as self-rated by participants were characterized across 12 cancer types: brain or central nervous system (CNS), breast, gastrointestinal, head and neck, gynecological, thyroid, lung and bronchus, sarcoma, genitourinary, melanoma, hematological, and all other cancers. Multivariable logistic regression was used to explore the associations between demographic, clinical, and symptom factors and moderate to severe cognitive symptoms.Across the sample of 5078 respondents (2820 females [55.5%]; mean [SD] age at time of survey, 56.0 [14.1] years) requesting psychosocial support, 3480 (68.5%) reported cognitive symptoms of any severity, ranging from 59.5% in sarcoma to 86.5% in brain or CNS cancer. Moderate to severe cognitive symptoms were reported by 1544 patients (30.4%), with the proportions being 51.3% for patients with brain or CNS, 37.0% for breast, 36.2% for thyroid, 30.9% for melanoma, 29.6% for head and neck, 28.3% for gastrointestinal, 28.2% for hematological, 28.1% for gynecological, 24.9% for lung and bronchus, 24.9% for sarcoma, 21.0% for genitourinary, and 26.8% for all other cancers. Across the entire sample, moderate to severe cognitive symptoms were associated with recurrence or progression involving the CNS (odds ratio [OR], 2.62; 95% CI, 1.80-3.81), depression (OR, 1.92; 95% CI, 1.59-2.31), tiredness (OR, 1.82; 95% CI, 1.52-2.19), drowsiness (OR, 1.64; 95% CI, 1.39-1.93), anxiety (OR, 1.57; 95% CI, 1.30-1.89), shortness of breath (OR, 1.38; 95% CI, 1.16-1.61), female sex (OR, 1.33; 95% CI, 1.14-1.56), first-line chemotherapy received (OR, 1.22; 95% CI, 1.05-1.41), and metastatic disease at diagnosis (OR, 0.74; 95% CI, 0.61-0.89). Within individual cancer types, tiredness and depression were consistently associated with moderate to severe cognitive symptoms.This cross-sectional study found that cognitive symptoms were frequently reported by patients across a wide range of cancer types; higher severity of cognitive symptoms was consistently associated with higher symptom burden. The findings could be used to inform decision-making regarding access to cognitive screening, assessment, and supportive care in outpatient oncology clinics.