Equity and Variation in Psychosocial Support for Children with Cancer: A Systematic Review of Pediatric Oncology Programs

Abstract

Childhood cancer represents a major global health challenge that extends beyond physical illness and treatment related complications. Children diagnosed with cancer and their families experience substantial psychosocial burdens, including anxiety, depression, emotional distress, social isolation, educational disruption, financial hardship, and long-term psychological consequences. Psychosocial support services have become an essential component of comprehensive pediatric oncology care, aiming to improve quality of life, treatment adherence, emotional well-being, and family functioning. Despite international recognition of psychosocial care standards, considerable variation exists in the availability, accessibility, quality, and equity of psychosocial support across pediatric oncology programs worldwide. This systematic review examines existing evidence regarding equity and variation in psychosocial support services for children with cancer across diverse healthcare settings. A comprehensive review of literature published between 2015 and 2025 was conducted using PubMed, Scopus, Web of Science, CINAHL, PsycINFO, and Google Scholar. Studies investigating psychosocial interventions, support programs, service accessibility, and healthcare disparities in pediatric oncology were included. Findings indicate substantial disparities in psychosocial care based on geographical location, socioeconomic status, healthcare resources, cultural factors, and institutional capacity. High-income countries generally provide multidisciplinary psychosocial services integrated into oncology care, whereas low- and middle-income countries frequently encounter workforce shortages, limited funding, and inadequate psychosocial infrastructure. Evidence suggests that psychosocial interventions improve emotional well-being, treatment adherence, family resilience, and quality of life. However, inequities persist, limiting access for vulnerable populations. The review concludes that strengthening psychosocial care infrastructure, expanding workforce capacity, implementing standardized care guidelines, and promoting equitable access are essential for improving outcomes among children with cancer globally.