Cancer patients with unmet supportive care needs are more likely to experience worse clinical outcomes, including more emergency department visits and hospitalizations, according to new research from Sylvester.

As reported in a paper published in June 2023 in the Journal of the American Medical Association, Sylvester researchers found that Black race, Hispanic ethnicity, and factors such as anxiety, depression, pain, poor physical function and low health-related quality-of-life scores were associated with a greater number of unmet needs, leading to increased risk for ED visits and hospitalizations. Unmet needs include financial, informational, psychological and physical challenges, but may vary across diagnoses.

“This is one of the first studies that assessed patients of diverse racial and ethnic backgrounds coming into a comprehensive cancer center for symptoms such as pain, fatigue, poor physical function, depression and anxiety,” said Frank J. Penedo, Ph.D., Sylvester’s associate director for Cancer Survivorship and Translational Behavioral Sciences and lead author of the JAMA article.

According to the American Cancer Society, advances in early detection and treatment have led to an increase in cancer survivorship. By 2032, there will be an estimated 22.5 million cancer survivors in the United States, a 24% increase over today. A recent systematic review found that up to 79% of survivors report at least one unmet need.

“Our findings support what we expected: that such unmet needs predict emergency room visits and hospitalizations,” said Dr. Penedo, who noted that researchers need to better understand the specific mechanisms and how the needs are related to clinical outcomes.

This retrospective analysis involved 5,236 patients treated at Sylvester’s various ambulatory cancer sites who used the My Wellness Check assessment, an electronic health record system that monitors patients’ emotional, physical and psychosocial needs. Patients are asked to complete the assessment 72 hours before most of their appointments. When a patient’s needs are identified, providers are notified in real time.

The study’s results also suggest that efforts to address unmet needs should target specific populations. Hispanics comprised almost 48% of study patients, while other racial groups included Black people, Caucasians, Asians, American Indians, Native Alaskans, Native Hawaiians and other Pacific Islanders. Moreover, social constructs, limited resources for racial and ethnic minority populations, and racism are associated with disparate health outcomes.