Systematic review and meta-analysis of unmet supportive care needs in 32,493 adults with cancer

OBJECTIVE: To estimate the levels of supportive care needs among adults with cancer using the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34) and to examine demographic, clinical, and treatment-related determinants. METHODS: A systematic review and meta-analysis was conducted (CRD42024604977). Studies reporting SCNS-SF34 scores in adults with cancer were included. Searches were performed across six different databases (November 2024; updated August 2025). Random-effects meta-analyses were undertaken to estimate the pooled mean scores across the five SCNS-SF34 domains and total score. Subgroup and meta-regression analyses explored potential determinants. RESULTS: Ninety-five studies (n = 32,493) were analysed. The unmet needs observed tended to be higher in the Health systems and information (Mean estimate [95% CI] = 38.4 [34.6-42.2]) and Psychological (Mean estimate [95% CI] = 35.9 [32.5-39.3]) domains, followed by Physical and daily living (Mean estimate [95% CI] = 31.2 [27.7-34.6]) and Patient care and support (Mean estimate [95% CI] = 30.0 [26.2-33.8]). The lowest needs were reported in the Sexuality domain (Mean estimate [95% CI] = 21.3 [18.1-24.5]). Cancer type influenced all domains, except for the psychological domain. Treatment status only influenced the health system and information domain. Older age was consistently associated with lower unmet needs in the health system and information, psychological and patient care and support domains, while surgical treatment was associated with lower needs in physical, patient care, and sexuality domains. CONCLUSIONS: The level of supportive care needs was identified, with informational and psychological domains representing the greatest burden. These needs vary according to cancer type, age, and treatment characteristics, supporting the need for tailored, multidisciplinary strategies to address unmet needs across the cancer continuum.