Social Needs in Cancer Survivors: A Scoping Review and Future Directions.

Abstract

Purpose of review: We conducted a scoping review to determine what is known about the prevalence and consequences of unmet social needs in U.S. cancer survivors, what screening tools are used to assess these needs, and what interventions have been developed to meet the needs of cancer survivors.  RECENT FINDINGS: We identified records from six databases. Inclusion criteria were peer-reviewed journal articles in English with empirical data from U.S.-based samples of people diagnosed with cancer as adults and assessing one of the following modifiable, individual-level needs commonly included in clinical screening: food insecurity, financial hardship, utility assistance, employment, housing, transportation, or personal safety. The search yielded 11,074 abstracts; 543 records underwent full-text review, and 189 were retained for data extraction. Most studies were quantitative and observational (88%), not based on theory (88%), and cross-sectional (87%). The majority addressed financial toxicity, commonly evaluated using the COmprehensive Score for financial Toxicity (COST). Fewer studies focused on food insecurity, transportation barriers, housing concerns, personal safety, or utility assistance. Included studies reported that financial toxicity and other social needs were negatively associated with health-related quality of life, mental health, and adherence to care.  Financial toxicity is now a well-established challenge for cancer patients, which suggests financial interventions may be widely beneficial. Future work is needed to develop a fuller picture of cancer survivors' other social needs, and to understand and address the impact of unmet social needs on clinical, health, and psychosocial outcomes.