Aims: Childhood cancer survival now exceeds 80%, creating a growing population living with the long-term consequences of cancer and treatment[1]. Despite supportive care being central to quality cancer care, evidence describing unmet supportive care needs among children and adolescents remains limited[2,3]. This review synthesised quantitative evidence on unmet supportive care needs among individuals diagnosed with cancer between 0 and 19 years and informed an integrated framework for supportive care delivery.
Methods: A systematic review was conducted according to PRISMA guidelines and registered with PROSPERO (CRD42022348261). APA PsycINFO, CINAHL and MEDLINE were searched for quantitative studies reporting unmet supportive care needs among children and adolescents diagnosed with cancer and/or their caregivers. Findings were synthesised narratively due to methodological heterogeneity.
Results: Of 9,966 records identified, nine studies involving 1,136 participants met inclusion criteria. Psychological and emotional concerns, including anxiety, uncertainty, distress and depression, were the most consistently reported unmet needs. Physical symptoms, fatigue, pain, functional limitations and treatment-related late effects were also common. Information and health system needs, particularly regarding follow-up care, late effects and survivorship planning, were prominent. Educational disruption, financial burden, social isolation, caregiver burden and family impacts were evident across the cancer trajectory. Ten supportive care domains were identified, demonstrating that unmet needs are persistent, multidimensional and interconnected.
Conclusions: Children and adolescents diagnosed with cancer experience complex unmet supportive care needs extending beyond treatment into survivorship. Findings informed a novel integrated conceptual framework positioning psychological, physical, informational, educational, social, family and practical needs as interconnected domains requiring coordinated multidisciplinary care. Routine multidomain screening, survivorship care planning and family-centred models of care should be prioritised to improve long-term outcomes.