-Original-

Unexpressed Support Needs and Social Distress in Working-Age Cancer Survivors: A Web-Based Cross-Sectional Study in Japan

Kazuho Hisamura^1,2, Miyo Kimura², Yoshiharu Motoo³ and Eisho Yoshikawa⁴

¹Department of Epidemiology and Public Health, School of Medicine, Kanazawa Medical University, Ishikawa, Japan
²Ishikawa Prefectural Cancer Support House, Ishikawa, Japan
³Department of Internal Medicine and Multidisciplinary Cancer Center, Fukui Saiseikai Hospital, Fukui, Japan
⁴Department of Medical Psychology, Nippon Medical School, Tokyo, Japan

Background: Cancer patients of working age often face multiple social challenges that remain unrecognized and unmet. The current study aimed to examine the adequacy of social support and unexpressed support needs for social problems among working-age cancer patients in Japan.
Methods: A web-based cross-sectional survey was conducted among 683 cancer patients aged 20-64 years. Using the Social Problem Checklist for Working-age Cancer Patients, we assessed the severity of social problems, the sources of support consulted, and the adequacy of support received. We analyzed differences in the adequacy of support by source and identified social problems associated with unexpressed and unmet support needs using dot diagrams.
Results: Although many participants experienced severe social problems, a substantial proportion reported either not perceiving a need for support or not expressing their support needs. Unexpressed needs were most common in domains related to loneliness, intimate relationships, and sexuality. Adequate support was more frequently reported when non-family sources were consulted, particularly when patients accessed both family and non-family support. Patients who relied solely on family reported support adequacy levels that were similar to those who consulted no one.
Conclusions: Many working-age cancer patients in Japan experience significant social distress but do not voice their support needs, particularly regarding sensitive topics. Support from non-family sources plays a key role in addressing unmet and unexpressed needs. These findings highlight the importance of multidisciplinary psychosocial care and proactive efforts to identify hidden distress and diversify support networks for working-age cancer patients.

J Nippon Med Sch 2026; 93: 37-48

Keywords
neoplasms, social support, psychosocial deprivation, unmet needs, adult

Correspondence to
Kazuho Hisamura
hisamura@kanazawa-med.ac.jp

Received, July 2, 2025
Accepted, September 17, 2025