The End-of-Life Wishes and Preferences of Adolescents with Cancer: A Scoping Review

There is a lack of qualitative and systematic literature exploring the wishes and preferences of adolescents with cancer and their connection to identity and emotional well-being. This scoping review aimed to identify and synthesize existing studies on the end-of-life (EOL) wishes and preferences of adolescents with cancer and examine how these wishes and preferences relate to identity and sense of self. The review was conducted to comprehensively explore and map the EOL wishes and preferences of adolescents with cancer, following the PRISMA-ScR guidelines. The PubMed, CINAHL, and Ichushi-Web (Japan Medical Abstracts Society) databases were searched from their inception until June 3, 2024. In addition, an updated search using PubMed was conducted on October 1, 2025. Overall, 7202 articles were screened, of which 8 were ultimately included. All studies were conducted in North America. Two were qualitative studies using semistructured interviews, revealing that adolescents with cancer expressed preferences related to treatment, place of care, and a desire to spend their final moments peacefully with their families. The remaining six studies were quantitative, including four randomized controlled trials evaluating the family-centered advance care planning for teens with cancer (FACE-TC) and two cross-sectional studies based on secondary analyses of FACE-TC session data. In conclusion, this scoping review highlights the need for further evidence accumulation across diverse regions and the limited number of qualitative studies exploring the EOL wishes and preferences of adolescents with cancer. Although Advance Care Planning tools, such as FACE-TC, have shown promise, challenges remain regarding their feasibility and adaptability in clinical practice. Adolescents' wishes and preferences are closely tied to their desire to be recognized as whole persons, not defined by cancer, and incorporating this perspective into care may support their identity. Future efforts should emphasize developmentally appropriate support and qualitative research to ensure that adolescent voices are heard and respected.