Screening for comprehensive social needs in patients with cancer: a narrative review

Abstract

Background: Patients with cancer who report social needs have worse quality of life, lower health-care access, and suboptimal health outcomes. However, screening for social needs does not happen systematically, and successful screening tools, strategies, and workflows have seldom been described. The downstream effects of screening including resource navigation have also not been well characterized. The objective of this narrative review was to fill these gaps.

Methods: Two investigators searched PubMed and Embase for studies that implemented a patient-facing social screening tool among patients with cancer between 2008 and 2023 using search terms including social screening, social needs, and cancer.

Results: We identified 19 articles that met study inclusion criteria. The most common tool used was the validated Health Leads Social Toolkit. Most often, screening tools were administered electronically, sent directly to patients, and captured needs at a single time point during a patient's diagnosis. Screening response rates ranged between 10% and 60%. Less than half of the studies described downstream resource navigation for patients who screened positive for social needs. Only 1 study evaluated the impact of screening on clinical outcomes and quality of life. Screening for patients who do not speak English or who belong to historically racial, ethnic, and gender minority groups was limited.

Conclusions: Screening for social needs has been shown to be feasible across delivery systems with numerous validated tools available. However, gaps remain in generalizability to diverse patient populations. Future work must identify how screening workflows can be successfully incorporated into routine clinical workflows.

Figure 1.

Consort diagram describing study inclusion.