Falling through the cracks: A review of psychological distress and psychosocial service needs in older Black and Hispanic patients with cancer

The U.S. population is growing older and becoming more ethnically diverse. Cancer is a disease of the elderly: 61% of cancer diagnoses and 70% of cancer deaths occur in patients above the age of 65. By 2050 there is an expected 99% increase in incidence of cancer in the ethnically diverse population; older ethnically diverse cancer patients will carry 28% of all cancer diagnoses. Among older patients with cancer, 41% experience emotional distress throughout the course of their illness; certain ethnic minority subpopulations may be at greater risk for high levels of distress. Older ethnically diverse cancer patients are significantly underrepresented in the psychosocial oncology literature. In an effort to highlight this gap in the psychosocial oncology literature, we conducted a systematic review of the literature on psychological distress in the geriatric oncology population, ethnic minority oncology populations namely, Blacks and Hispanics. The psychosocial barriers, protective factors and service needs in these populations are reviewed, and the relationship between needs and distress are discussed. It is apparent there is a lack of research aimed at older Black and Hispanic cancer patients; the prevalence and nature of psychological distress and psychosocial needs in this population are unknown. Future research is needed in this understudied area to document the basic information regarding the prevalence and nature of psychological distress in this population.