Background: Australia has psychosocial support guidelines and recommendations for adolescents or young adults (AYAs) diagnosed with cancer, as well as guidelines applicable across all ages. However, people with early-onset cancers (diagnosed at ages 20-49) may have distinct psychosocial support needs, warranting age-specific guidance.
Method: We conducted a scoping review of international systematic reviews and Australian studies examining psychosocial impacts of cancer in people with early-onset cancer. We also summarised Australian psychosocial support guidelines and recommendations, including their focus on early-onset cancers, development processes, and implementation and evaluation plans. Findings were synthesised to assess the need for, and potential approaches to, developing psychosocial support guidelines for Australians with early-onset cancers.
Results: International evidence primarily focussed on AYAs (most often 15-39 years) and identified psychosocial challenges across psychological wellbeing, social connectedness, sexual and reproductive health, coping, education and employment, and health-related quality of life. Australian evidence was limited and also largely focussed on AYAs (typically defined as 15-24 or 15-25 years). Reported issues included lack of survivorship care plans, poor information sharing, unmanaged treatment side effects, inadequate sexual health counselling, and employment loss associated with neurocognitive complications. Psychosocial needs are likely to vary by age group and by sex and gender, but evidence was sparse. Existing Australian guidelines varied in scope and detail, ranging from clinical assessment and referral recommendations to broader psychosocial care guidance. Guideline development processes also differed in their evidence reviews, stakeholder engagement, and implementation and evaluation planning.
Conclusions: Cancer-related psychosocial impacts of cancer are substantial and likely to differ for people with early-onset cancer. More Australian evidence is needed, particularly for people aged 26-49 years and by age group, sex and gender and for identified priority populations. Australian psychosocial support guidelines tailored to early-onset cancer are warranted and could build on methodologies, expertise and frameworks from existing guidelines.