UNMET NEEDS OF CANCER SURVIVORS IN IRELAND: A SCOPING REVIEW OF THE EXISTING EVIDENCE

Background Due to advances in treatment and new drugs, more people in Ireland are surviving cancer. However, evidence is accumulating that cancer survivors have ongoing (and often unmet) needs for support and care. Supportive care interventions are required to meet these needs and maximise survivors’ quality-of-life. International research illustrates the importance of targeting interventions to the specific needs and characteristics of the recipients. In order to address these variable needs, a better understanding of the unmet needs patients living with and beyond cancer is required. We conducted a scoping review of the current evidence on the unmet physical, emotional, practical and social needs of those living with and beyond cancer in Ireland. Methods Five databases were searched to identify studies conducted in Ireland, published between 1998 and 2018. Studies reporting on adult survivors of childhood cancer, those including participants aged ≤17 years, and those which reported on palliative care services were excluded. Unmet needs were classified into eleven primary domains including physical, psychosocial/emotional, family-related, social, practical, health system/information and patient-clinician communication needs. A narrative synthesis of the data was undertaken. Results 28 studies were included in the review consisting of both quantitative and qualitative studies. Most studies examined unmet needs between 1–3 yrs post treatment and the most frequently studied cancers were prostate, colorectal and breast cancer. Although melanoma, testicular and kidney cancers contribute significantly to total cancer prevalence, these received little attention in the Irish survivorship literature. Unmet physical, psychological and information needs were common across all cancer types with clear evidence of inter-relationships between various unmet needs. This review also identified significant gaps in the literature in relation to a lack of availability of longitudinal data as well as a lack of information about the relationship between unmet needs and survivors’ socio-demographic characteristics. Conclusion As far as we are aware, this is the first scoping review of its kind conducted in Ireland. Gaps in the evidence-base for unmet needs, suggests that limited research has been conducted to understand the care needs of Irish cancer survivors. The planning and design of survivorship strategies in Ireland would benefit from routine collection of detailed information, with specific unmet need survey instruments, across multiple diseases. The National Cancer Strategy has identified survivorship care as a key challenge until 2026. The findings of this scoping review further reinforces the importance of enhancing survivorship services to address the unmet needs of cancer survivors.