Age-related differences in unmet needs and their predictors among adults with bladder cancer

BACKGROUND: Bladder cancer disproportionately affects older adults, making addressing age-specific unmet needs essential. Understanding how sociodemographic, clinical, and personal/social resource factors influence unmet needs can help clinicians deliver tailored interventions to improve outcomes.

OBJECTIVES: (1) Examine differences in unmet needs for patients aged <65 and ≥65, and (2) determine sociodemographic, clinical, and personal/social resource factors associated with unmet needs for patients aged <65 and ≥65.

METHODS: We conducted a cross-sectional study of survey data for adults aged 18 to 85 from the Bladder Cancer Advocacy Network. Unmet needs were identified a priori (psychological, health system and information, physical/daily living, patient care/support, sexuality, logistics, communication with a spouse/partner, and communication with clinicians) and assessed using the Bladder Cancer Needs Assessment Scale-32. Univariate analyses and backward model selection were used to identify sociodemographic, clinical, and personal/social resource variables associated with unmet needs for patients <65 and ≥65.

RESULTS: Overall, 155 patients with bladder cancer were included. Patients <65 had more psychological, patient care and support, sexuality, and communication with spouse/partner unmet needs, while patients ≥65 had more health system and information unmet needs. Multivariable analyses revealed significant differences in associations between unmet needs and social support, self-efficacy, and maladaptive coping for each distinct age group. Differences in unmet needs by patient sex emerged, with women experiencing more unmet needs than men in the older group.

CONCLUSION: Findings underscore the need for tailored supportive care strategies accounting for how age, patient sex, and personal/social resources may impact unmet needs to improve bladder cancer care and outcomes.