Psychological outcomes in ethnically minoritised adolescents and young adults with cancer: A systematic review.

Background: Ethnic disparities in cancer prevalence 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 complex needs along their developmental trajectories. The present review aimed to examine psychological outcomes amongst ethnically minoritised adolescents and young adults (AYAs) with cancer.

Method: A systematic search was conducted on four databases using terms related to AYAs, cancer, ethnic minority and psychological outcomes. Quantitative studies of any design were included and screened against the eligibility criteria. Studies were rated for methodological quality and synthesised narratively.

Results: Twelve studies conducted in the United States were identified with mostly moderate to low quality and the evidence was mixed. Six studies found ethnic disparities in psychological outcomes: the majority demonstrated that ethnically minoritised AYAs experienced significantly more distress compared to White peers with cancer. Hispanic youths were highlighted as a vulnerable group that fared worse in their mental health compared to other minoritised youths. Longitudinal data showed that minoritised AYAs experienced more marked improvement in their psychological health over time compared to Caucasians.

Conclusion: There is emerging evidence regarding inter-ethnic differences in psychological outcomes amongst AYAs with cancer. However, the findings are inconsistent, reflecting methodological weaknesses and the complexities of intersectionality impacting on mental health. Further cross-cultural research is necessary to substantiate these findings and elucidate mechanisms behind these inequalities to promote more equitable healthcare.