Background
Ethnic disparities in cancer prevalence, prognosis and health outcomes have been widely documented in adults. However, less is known about the impact of ethnic differences in young cancer patients who present with unique challenges and complex needs along their developmental trajectories. The present review aims to examine psychological outcomes amongst ethnically minoritised adolescents and young adults with cancer. Method
A systematic search was conducted on PsycINFO, PubMed, Web of Science and CINAHL using terms related to adolescents and young adults, cancer, ethnic minority and psychological outcomes. Quantitative studies of any design that were published after 2000 were included in the review and were screened against the eligibility criteria. Assessment of methodological quality was carried out using a standardised tool. Data were extracted and synthesised narratively. Results
Twelve studies conducted in the United States were identified. Participants were aged between 14 to 40 years old, had heterogeneous cancer diagnoses, stages and treatment status. The methodological quality of the studies reviewed was mostly moderate to low and the evidence was mixed. Six studies found ethnic disparities in psychological outcomes: the majority demonstrated that ethnically minoritised adolescents and young adults experienced significantly more distress and lower quality of life compared to White peers with cancer. Hispanic young patients, in particular, were highlighted as a vulnerable group that fared worse in their mental health compared to other minoritised youths. Longitudinal data showed that minoritised adolescents and young adults experienced more marked improvement in their psychological health over time in contrast to the Caucasian group. Conclusion
There is emerging evidence regarding inter-ethnic differences in psychological outcomes amongst adolescents and young adults with cancer. However, the findings are inconsistent, reflecting methodological weaknesses and the complexities of intersectionality impacting on mental health. More attention on cross-cultural research is needed to substantiate these results and to elucidate mechanisms behind these inequalities in order to contribute towards more equitable quality and access to healthcare. |