Researchers led by Alice Treloar and Susanna B. Park of the University of Sydney set out to test whether brief patient-reported questionnaires could be woven into everyday cancer care at two oncology centres in Sydney, Australia. Between March 2022 and November 2023, they recruited 159 adults who were receiving or about to receive neurotoxic chemotherapy, including platinum, taxane, anti-microtubule, vinca alkaloid, and bortezomib-based regimens. The screening package, dubbed CIPN-Screen, combined three short patient-reported outcome measures: the two-item sensory neuropathy subscale of the National Cancer Institute’s PRO-CTCAE, the two-item Patient Neurotoxicity Questionnaire, and the 11-item EviQ online neurotoxicity instrument. Anyone reporting symptoms was invited to complete the longer 20-item EORTC QLQ-CIPN-20 questionnaire to characterise the impact of their symptoms in more detail.

The crucial difference between the two sites was how patients were asked to participate. At the first centre, clinical staff approached patients during chemotherapy visits and offered a QR code or paper copy, a model that depended entirely on busy nurses and doctors remembering to hand out surveys. At the second centre, patients were enrolled once and then received an automated text message reminder before every chemotherapy appointment, requiring no ongoing input from clinical staff whatsoever. The contrast in results was striking. The staff-driven site produced just 109 completed screens across 75 participants, with a median of a single screen per person. The text-message site generated 646 screens among 84 participants, with a median of eight screens per patient, all completed online.

In total, 755 screening episodes were collected, and the data they yielded paint a sobering picture of neuropathy in the chemotherapy population. Just over 56 percent of screens identified CIPN symptoms, and 18.3 percent detected moderate to severe symptoms on the PRO-CTCAE scale. Roughly a third of screens at both centres indicated that the neuropathy was having a functional impact. Patients reported that nerve symptoms interfered with sleep, breathing, buttoning clothes, working, and walking. Notably, the proportion of symptomatic patients and the severity distribution were almost identical between the two centres, despite their very different demographics and delivery methods, suggesting the screening tools themselves were capturing something real and consistent.

Acceptability, the make-or-break factor for any screening programme, was overwhelmingly positive. Across all screens, 92 percent of respondents agreed or strongly agreed that CIPN-Screen was easy to complete, 91.6 percent found it easy to understand, and 85.6 percent said it helped them describe their symptoms. Acceptability held steady regardless of age, sex, or chemotherapy type, and it did not fade with repeated use: responses to the acceptability questions did not change significantly between the first and sixth screens. Interestingly, however, patients with moderate to severe symptoms rated the tool slightly less favourably than those with mild or no symptoms, particularly on the question of whether it helped them describe what they were feeling. The authors speculate that very brief questionnaires may not capture the full range of symptoms experienced by the worst-affected patients, who may also need more clinical input than a short survey can trigger.

The study also demonstrated something scientifically important: the screening tool was responsive to change. Among 52 participants at the text-message centre who completed seven consecutive screens over a median of 49 days, the proportion reporting CIPN symptoms rose from 27 percent at the first screen to 63 percent by the seventh, a statistically significant trajectory that tracked the cumulative neurotoxicity of ongoing treatment. In other words, the brief questionnaires did not merely snapshot a moment; they charted the emergence and worsening of nerve damage across a chemotherapy course. This longitudinal sensitivity is exactly what clinicians would need to make informed decisions about dose modification before irreversible damage sets in.

The three short instruments also agreed strongly with one another, with correlation coefficients of 0.84 or higher for most pairwise comparisons, and the PRO-CTCAE severity grades differentiated scores on the longer CIPN-20 questionnaire with high statistical significance. This internal consistency matters because it suggests clinics could reasonably pick a single brief instrument rather than deploying a battery of surveys. Prior Delphi consensus work has indicated that questionnaires longer than three items rate poorly for feasibility in busy infusion units, so a validated two-item screener that correlates well with comprehensive instruments is an attractive proposition for real-world oncology.

Patients, however, are only half of the implementation equation. The researchers also surveyed 31 clinicians, including medical and nursing staff and allied health personnel, using the adapted Organisational Readiness for Implementing Change questionnaire. Both centres scored in the mid-range for readiness for change, with mean scores of 43.5 and 46.4. Encouragingly, the highest-rated items concerned motivation: around 85 to 89 percent of clinicians at each site agreed that their colleagues wanted to implement CIPN screening. The weakest link was confidence in navigating the organisational politics of implementation, where agreement fell to between 39 and 46 percent. The authors argue that this gap between willingness and organisational confidence is precisely where tailored implementation strategies, staff training, and integration with electronic medical records must focus.

The study has honest limitations. It was a clinical implementation study rather than a randomised trial, so delivery methods differed by site and the cohorts skewed young and female, dominated by breast cancer patients at the text-message centre. Screening information was not fed back into clinical decisions, so the researchers could not measure whether enhanced screening actually reduced dose interruptions or chronic neuropathy, and no neurological examination was performed to confirm diagnoses. The authors also note that automated electronic collection could disadvantage patients less comfortable with digital tools, and that CIPN itself can impair the hand function needed to complete electronic surveys.

Even so, the central message is hard to ignore. A two-item questionnaire, delivered by an automated text message tied to a chemotherapy appointment, achieved near-perfect completion rates, detected symptom evolution over time, and required almost no clinician labour. International guidelines already endorse electronic symptom monitoring in cancer care, and large real-world programmes in Europe have shown high patient compliance and meaningful reductions in symptom burden. What this study adds is a concrete demonstration that CIPN screening specifically can be automated, scaled, and tolerated by patients across age groups and treatment types. The next step, the researchers say, is embedding such tools into electronic medical records with real-time delivery of results to treating clinicians, and pairing screening with guided clinical pathways so that a flagged symptom actually changes management. For the millions of cancer survivors living with numb hands and unsteady feet, a routine text message that catches nerve damage early could make the difference between a temporary side effect and a lifelong disability.

Subject of Research: Feasibility and acceptability of patient-reported screening for chemotherapy-induced peripheral neuropathy in routine cancer care

Article Title: Feasibility of clinical implementation and acceptability of patient-reported screening for chemotherapy-induced peripheral neuropathy (CIPN)

Article References: Treloar, A., Grimison, P., Choi, V., Young, J., Mayer, K., Li, T., Boyle, F., King, T., Mizrahi, D., Horvath, L. G., Goldstein, D., & Park, S. B. (2026). Feasibility of clinical implementation and acceptability of patient-reported screening for chemotherapy-induced peripheral neuropathy (CIPN). Supportive Care in Cancer, 34(11), Article 1073. https://doi.org/10.1007/s00520-026-11296-4

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11296-4

Keywords: chemotherapy-induced peripheral neuropathy, CIPN, patient-reported outcome measures, cancer screening, supportive care, text message reminders, PRO-CTCAE, oncology, neurotoxicity, cancer survivors, clinical implementation, symptom monitoring