Mapping of Preoperative Screening Tools Reveals Urgent Need for Standardization in Gastrointestinal Cancer Surgery: A Scoping Review

BACKGROUND: Gastrointestinal (GI) cancers are a major global health challenge due to their high incidence, mortality, and surgical complication rates. Preoperative physical, nutritional, and psychological vulnerabilities increase the risk of adverse surgical outcomes. Despite this, there is currently no validated, self-report screening tool integrating assessment across all three domains. This scoping review aims to identify and describe existing preoperative screening tools used to assess modifiable physical, nutritional, and psychological domains in adult patients undergoing elective GI cancer surgery. METHODS: We conducted this scoping review in accordance with Arksey and O'Malley's framework and PRISMA-ScR guidelines. Searches were performed across MEDLINE, EMBASE, CINAHL, EBM, and PsycINFO date limited from January 2000 to March 2025. Studies were included if they evaluated preoperative screening tools for physical, nutritional, and/or psychological assessment in adult patients undergoing GI cancer surgery. Data on tool characteristics, domains assessed, administration time, and psychometric properties were extracted and synthesized descriptively. RESULTS: From 2825 initial records, 121 studies were included, encompassing 77 unique screening tools. These were categorized as physical (n = 21), nutritional (n = 16), and psychological (n = 40) tools. Most tools were brief (1-15 items). CONCLUSIONS: Although most screening tools are brief, feasible for self-administration, and freely accessible, none integrated all three domains. Substantial heterogeneity in tools highlights the need for a comprehensive, validated multidomain preoperative screening tool for this population.