Examining unmet needs in older adults with lung cancer: A systematic review and narrative synthesis.

Introduction: Unmet needs in the older population with cancer are complex due to aging-related health conditions. A review of unmet needs in older people with cancer showed that needs varied among different cancer types. In lung cancer, a higher incidence of geriatric syndromes and comorbidities exist compared to other cancer cohorts, impacting treatment tolerance and completion. Consequently, it is crucial to identify and understand unmet needs to address supportive care needs beyond cancer diagnosis and treatment. This systematic review aims to synthesise the available literature to analyse the number and nature of unmet needs experienced by older patients with lung cancer.

Materials and methods: We performed a systematic search following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, which was registered in PROSPERO(CRD42022311105). We searched CINAHL, Medline, Embase, and Scopus electronic databases for published literature (January 2002 to November 2023) on unmet needs of patients ≥65 years diagnosed with lung cancer. We used a narrative synthesis approach to summarise the results and identify themes.

Results: The search yielded 1356 articles, of which 35 met the inclusion criteria. A significant portion of older patients with lung cancer reported experiencing unmet needs, ranging from 78 % to100 %. Compared to other cancer streams, older patients with lung cancer experienced a higher burden of unmet needs, with a mean of seven unmet needs per person. Most studies identified psychological and physical/daily living domains as having the greatest prevalence and highest burden of unmet need.

Discussion: Increased psychological distress and poorer quality of life correlated with increased unmet needs. Identifying and addressing unmet needs is critical for patient wellbeing and should be prioritised when developing models of care and tailored interventions for older people with lung cancer.