Mapping unmet supportive care needs, quality-of-life perceptions and current symptoms in cancer survivors across the Asia-Pacific region: results from the International STEP Study

A. Molassiotis, P. Yates, Q. Li, W.K.W. So, K. Pongthavornkamol, P. Pittayapan, H. Komatsu, M. Thandar, M. Yi, S. Titus Chacko, V. Lopez, J. Butcon, D. Wyld, R.J. Chan, the STEP Study Collaborators, Melissa Doolan, Maria Estrella Litam, Rubiliza Onofre, Conchitina Lluch, Rosebe Nacion, Maria Luisa Ombao, Zaw Wai Soe, Theingi Myint, Emily Ang, Harue Arao, Kaori Yagasaki, Vinitha Ravindran, Roselin V. Rhenius, Amalorpavamari Lucas, Lillian Percy Kujur, Abijah Princy, Kai-chow Choi, Yin-ping Choy, Yan-pui Lee, Chun-yip Shiu, Yinghua Xu

To assess the supportive care needs, quality of life (QoL) and symptoms of patients with cancer after the end of first-line treatments and into survivorship in Asian countries using Australian data as benchmark. A cross-sectional survey was carried out in Australia and eight high-income (HICs) and low-/middle-income (LMICs) Asian countries (China, Japan, Hong Kong SAR, South Korea, Myanmar, Thailand, India, Philippines) using validated scales (Cancer Survivors Unmet Needs scale), physical-symptom concerns (Cancer Survivors Survey of Needs subscale) and a single-item measure of global QoL perception. Data were collected from 1748 patients from nine countries. QoL was highest in Australia and all other countries had significantly lower QoL than Australia (all P < 0.001). One-quarter of the patients reported low QoL (scores 1-3/10). The most frequently reported symptoms were fatigue (66.6%), loss of strength (61.8%), pain (61.6%), sleep disturbance (60.1%), and weight changes (57.7%), with no difference in symptom experience between Australian data and all other countries, or between HICs and LMICs. Unmet needs of moderate/strong level were particularly high in all aspects assessed, particularly in the area of existential survivorship (psychosocial care) and receiving comprehensive cancer care. Australia and HICs were similar in terms of unmet needs (all low), but LMICs had a significantly higher number of needs both compared with Australia and HICs (all P < 0.001). Health care systems in Asian countries need to re-think and prioritize survivorship cancer care and put action plans in place to overcome some of the challenges surrounding the delivery of optimal supportive cancer care, use available resource-stratified guidelines for supportive care and test efficient and cost-effective models of survivorship care.