Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer Wylie W. Y. Li 1 , Wendy W. T. Lam 1 *, Angel H. Y. Au 1 , Michelle Ye 1 , Wai Lun Law 2 , Jensen Poon 2 , Ava Kwong 3 , Dacita Suen 3 , Janice Tsang 4 , Afaf Girgis 5 and Richard Fielding 1 1 Centre for Psycho-oncology Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China 2 Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China 3 Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China 4 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China 5 Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia *Correspondence to: Centre for Psycho-oncological Research and Training, Department of Community Medicine and Unit for Behavioural Sciences, School of Public Health, The University of Hong Kong, 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong, China. E-mail: wwtlam@hku.hk Received: 19 December 2011 Revised: 15 February 2012 Accepted: 24 February 2012 Abstract Background: Understanding cancer patients’ supportive care needs can help optimize health-care systems and inform services development. We therefore examined the prevalence of supportive care needs in Chinese breast (BC) and colorectal cancer (CRC) patients to identify prevalence and correlates of unmet needs. Methods: We assessed supportive care needs (Supportive Care Needs Survey—Short Form), psychological distress (the Hospital Anxiety and Depression Scale), symptom distress (The Memorial Symptom Assessment Scale—Short Form), and satisfaction with care (Patient Satisfaction Questionnaire) among 210 Chinese BC (97) or CRC (104) outpatient clinic attendees. Results: Breast cancer patients (89.7%) reported more unmet needs (x 2 = 4.409, p = 0.027), but both CRC and BC samples ranked unmet needs prevalence similarly, with health system and information needs reported as the most common. Younger patients reported higher health system and information and sexuality needs. After multivariate adjustment, the strength of unmet needs did not differ by cancer type. Unmet psychological, physical and daily living, and sexuality needs were positively associated with greater symptom distress. Greater health system information needs were associated with high global distress and low depression scores, whereas greater psychological needs were associated with higher anxiety scores. Conclusions: Hong Kong Chinese BC and CRC patients strongly prioritized needs related to health systems and information provision. Symptoms and psychological distress were associated with unmet needs, reflecting a service shortfall in symptom management. Improving care provision by optimizing communication and clinic organization can better prepare cancer patients for their rehabilitation and improve symptom control. Copyright © 2012 John Wiley & Sons, Ltd. Introduction Aging populations, improved treatment, and survival mean more people are living with cancer [1]. Breast cancer (BC) is the most commonly diagnosed cancer in women with 1.38 million new cases globally in 2008, whereas colorec- tal cancer (CRC) is the third most frequently diagnosed cancer in men and the second in women, with 1.2 million new cases in 2008 [1]. In Hong Kong, BC is the most com- mon cancer affecting women, whereas colorectal cancer is the second most common cancer affecting both sexes [2]. CRC is projected to be the predominant cancer in Hong Kong within 5 years [2]. In both cases, primary treatment involves surgery, with adjuvant chemotherapy. For BC, adjuvant radiation therapy may be used. Although CRC [3] and BC [4] patients experience different patterns of psychological distress following diagnosis and treatment, more BC patients report distress. Quality of life is also differentially affected [5,6], with worse daily functioning reported by BC than CRC patients. Psychological distress and quality of life reflect subjective states, but many cancer patients face informational or practical difficulties arising from cancer and treatment. Supportive care needs such as managing poor body image, anxiety, or relationship diffi- culties vary. Helping patients address these needs requires knowing the need frequency and type, enabling health-care systems to identify and implement appropriate services. Some research documenting the unmet supportive care needs of western (including Australian) populations of mixed groups of cancer patients suggests greater unmet needs surrounding health systems, information giving, and physical and daily living issues compared to psychological, care/support, and sexuality issues [7–9]. Conversely, British patients with different cancers reported higher psychologi- cal unmet needs, with health-care needs being mostly satisfied [8]. Thus, unmet supportive care need patterns Copyright © 2012 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology (2012) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3068