Psychosocial challenges among Asian adolescents and young adults with cancer: a scoping review

Most of the landmark cohorts and reviews that assessed the psychosocial outcomes among adolescent and young adult (AYA) cancer survivors have focused on Western populations. This scoping review summarizes the existing evidence on psychosocial challenges experienced by AYAs with cancer in Asia, specifically work- and school-related outcomes, financial distress, social relationships, and concerns with infertility.

A literature search was conducted on Embase and Medline for studies that (1) were published in English between 2000 and 2023, (2) recruited AYAs diagnosed with cancer between the age of 15 and 39 years, (3) were conducted in Asia, and (4) assessed outcomes related to (i) work or/and school performance, (ii) financial distress, (iii) romantic relationship or/and relationship with family and peers, and (iii) concerns with childbirth and infertility. Titles, abstracts, and full texts were screened independently by two reviewers to identify eligible studies. Information of included studies was summarized and aggregated using structured forms based on Joanna Briggs Institute's (JBI) data extraction form. Both quantitative and qualitative studies were assessed for methodological validity using JBI Critical Appraisal Checklist.

Thirteen studies, enrolling a total of 1,108 survivors, reported outcomes related to work or school performance (n = 8), relationships with families and peers (n = 5), and desires or concerns regarding childbirth or infertility (n = 5). Although no differences in resignation rates between AYA survivors of cancer and non-cancer controls or other age groups were reported in three studies, 21%-40% of AYAs expressed concerns regarding employment or impaired work outcomes after cancer diagnosis. Studies identified health concerns and socioenvironmental factors that affected family functioning and romantic relationships. The uncertainty and the lack of information on fertility preservation were consistently reported by participants.

Our review demonstrated differences in concerns and disparities in social support and interventions available to AYA cancer survivors among various Asian countries/regions. We found Asian studies have focused more on family relationships than peers, likely due to sociocultural nuances when compared with Western societies. Given the variability in economic development and healthcare infrastructure across Asia, region-specific healthcare policies and services are required for AYA survivors.