{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:56:23Z","timestamp":1776056183881,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Breast and cervical cancers are the leading causes of cancer related morbidity and mortality among Ethiopian women. These cancers carry burdens including impacts on femininity, marital relationships, and family stability. Yet palliative care (PC) remains under addressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed unmet PC needs and determinants among women with breast and cervical cancer and caregiver burden in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Institution based cross sectional study was conducted from February to April, 2025 at Tikur Anbessa Specialized Hospital, and Hawassa University Comprehensive Specialized Hospital, Ethiopia. Using systematic random sampling, 480 patients and 458 caregivers were enrolled. Data were collected using Supportive and Palliative Care Indicators Tool for Low Income Settings, African Palliative Care Association tool, and the three item Oslo Social Support Scale. Multivariable logistic regression identified factors associated with higher PC needs. Statistical significance set at p \u2264 0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Using the mean as the threshold for dichotomisation, 261 patients (54.4%) were having higher PC needs. Psychosocial distress was prevalent domain (72.1%), followed by economic hardship (62.3%), physical symptoms (56.7%), and spiritual concerns (52.9%). Breast cancer patients reported higher psychosocial distress than cervical cancer patients (75.6%\n                      <jats:italic>vs<\/jats:italic>\n                      . 66.5%, p = 0.03). Patients in Sidama had higher unmet needs (74.6%) than in Addis Ababa (51.5%, p = 0.001). Among cervical cancer patients, chemotherapy receipt was the predictor (AOR\u00a0=\u00a04.21, 95% CI: 2.18\u20138.13); among breast cancer patients, late stage diagnosis was associated (AOR\u00a0=\u00a02.84, 95% CI: 1.52\u20135.31). Difficulty accessing hospitals (AOR\u00a0=\u00a01.89, 95% CI: 1.02\u20133.66), preference for local PC (AOR\u00a0=\u00a02.65, 95% CI: 1.15\u20136.10), and Muslim religious affiliation for cervical cancer (AOR\u00a0=\u00a02.35, 95% CI: 1.02\u20135.41) and breast cancer (AOR\u00a0=\u00a02.18, 95% CI: 1.01\u20134.70) were linked to higher PC needs. Social support was protective (AOR\u00a0=\u00a00.30). 75.5% caregiver reported high emotional strain and 59.8% high financial burden.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Psychosocial distress was the most common need requiring comprehensive PC service. Given the protective role of social support and patient preference for local care, community based PC models should be integrated into primary health systems. The caregiver burden demands investment in caregiver support programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1788481","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:38:22Z","timestamp":1776055102000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unmet palliative care needs and determinants among women with breast and cervical cancer and their caregivers in Ethiopia"],"prefix":"10.3389","volume":"16","author":[{"given":"Kalkidan Solomon","family":"Deribe","sequence":"first","affiliation":[{"name":"College of Health Sciences, School of Public Health, Addis Ababa University","place":["Addis Ababa, Ethiopia"]},{"name":"Global and Planetary Health Working Group, Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarona","family":"Shewaye","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Public Health, Addis Ababa University","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigiya","family":"Wondimagegnehu","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Public Health, Addis Ababa University","place":["Addis Ababa, Ethiopia"]},{"name":"Global and Planetary Health Working Group, Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoseph Mamo","family":"Azmera","sequence":"additional","affiliation":[{"name":"Global Health Partnership","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adamu","family":"Addissie","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Public Health, Addis Ababa University","place":["Addis Ababa, Ethiopia"]},{"name":"Global and Planetary Health Working Group, Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva J.","family":"Kantelhardt","sequence":"additional","affiliation":[{"name":"Global and Planetary Health Working Group, Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]},{"name":"Department of Gynaecology, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirgissa","family":"Kaba","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Public Health, Addis Ababa University","place":["Addis Ababa, Ethiopia"]},{"name":"Global and Planetary Health Working Group, Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle Wittenberg","place":["Halle (Saale), Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-023-01060-9","article-title":"Integrating palliative care into oncology care worldwide: the right care in the right place at the right time","volume":"24","author":"Castro","year":"2023","journal-title":"Curr Treat Options Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1056\/nejmp1113622","article-title":"Painful inequities \u2014 palliative care in developing countries","volume":"366","author":"Lamas","year":"2012","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/20503121221092338","article-title":"Knowledge and associated factors towards palliative care among nurses in Ethiopia: a systematic review and meta-analysis","volume":"10","author":"Wake","year":"2022","journal-title":"SAGE Open Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1177\/1178224218819745","article-title":"Palliative care and public health: an asymmetrical relationship","volume":"12","author":"Whitelaw","year":"2019","journal-title":"Palliat Care"},{"key":"B5","volume-title":"APCA atlas of palliative care in Africa","author":"Pons-Izquierdo","year":"2017"},{"key":"B6","volume-title":"Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2019 global survey","year":"2019"},{"key":"B7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s12904-023-01181-w","article-title":"Barrier analysis for continuity of palliative care from health facility to household among adult cancer patients in Addis Ababa, Ethiopia","volume":"22","author":"Abate","year":"2023","journal-title":"BMC Palliat Care"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2007.11.012","article-title":"Overcoming challenges of cancer treatment programmes in developing countries: a sustainable breast cancer initiative in Ethiopia","volume":"20","author":"Reeler","year":"2008","journal-title":"Clin Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1177\/0020872815617993","article-title":"Psychosocial experiences and needs of women diagnosed with cervical cancer in Ethiopia","volume":"60","author":"Kebede","year":"2017","journal-title":"Int Soc Work"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248738","article-title":"Palliative care needs and preferences of female patients and their caregivers in Ethiopia: a rapid program evaluation in Addis Ababa and Sidama zone","volume":"16","author":"Kaba","year":"2021","journal-title":"PloS One"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdl983","article-title":"The rising burden of cancer in the developing world","volume":"17","author":"Kanavos","year":"2006","journal-title":"Ann Oncol"},{"key":"B12","volume-title":"National palliative care guideline","year":"2016"},{"key":"B13","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s40359-018-0249-9","article-title":"Social support in the general population: standardization of the Oslo social support scale (OSSS-3)","volume":"6","author":"Kocalevent","year":"2018","journal-title":"BMC Psychol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2022-100871","article-title":"Cancer-related psychosocial challenges","volume":"35","author":"Wang","year":"2022","journal-title":"Gen Psychiatr"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5516","article-title":"The psychosocial cost burden of cancer: a systematic literature review","volume":"29","author":"Essue","year":"2020","journal-title":"Psychooncology"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003232","article-title":"Experience and perspectives on palliative or end-of-life care of Chinese people and their families as immigrants to high-income countries: a systematic review and thematic synthesis","volume":"5","author":"Kwok","year":"2020","journal-title":"BMJ Glob Health"},{"key":"B17","volume-title":"Barriers and facilitators to culturally appropriate cancer health education for Kenyan immigrants in Washington State","author":"Odengo","year":"2024"},{"key":"B18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s12877-016-0282-6","article-title":"A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review","volume":"16","author":"Fang","year":"2016","journal-title":"BMC Geriatr"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-d-19-00270","article-title":"End-of-life treatment decisions in adult Muslims: a scoping review protocol","volume":"18","author":"Malas","year":"2020","journal-title":"JBI Evid Synth"},{"key":"B20","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12904-025-01759-6","article-title":"Managing cultural diversity in end-of-life care: a qualitative study","volume":"24","author":"C\u00e1ceres-Titos","year":"2025","journal-title":"BMC Palliat Care"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2147\/jpr.s415866","article-title":"Challenges in palliative care provision in Ethiopia: an exploratory qualitative study","volume":"16","author":"Negasa","year":"2023","journal-title":"J Pain Res"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.62.1615","article-title":"Provision of palliative care in low- and middle-income countries: overcoming obstacles for effective treatment delivery","volume":"34","author":"Hannon","year":"2016","journal-title":"J Clin Oncol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s12904-023-01263-9","article-title":"Access to palliative care in patients with advanced cancer of the uterine cervix in the low- and middle-income countries: a systematic review","volume":"22","author":"Ooko","year":"2023","journal-title":"BMC Palliat Care"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czaa051","article-title":"Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review","volume":"35","author":"Aregay","year":"2020","journal-title":"Health Policy Plan"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.62754\/joe.v3i8.5319","article-title":"Critical analysis of healthcare delivery models: addressing gaps in accessibility, quality, and efficiency","volume":"3","author":"Al Johani","year":"2024","journal-title":"J Ecohumanism"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244395","article-title":"Barriers to healthcare access and healthcare seeking for childhood illnesses among childbearing women in sub-Saharan Africa: a multilevel modelling of Demographic and Health Surveys","volume":"16","author":"Ahinkorah","year":"2021","journal-title":"PloS One"},{"key":"B27","volume-title":"Socioecological factors influencing the anticipated medical help-seeking time for breast cancer among women in Togo, a Sub-Saharan country","author":"Aheto","year":"2024"},{"key":"B28","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12904-022-00904-9","article-title":"Conceptualising effective symptom management in palliative care: a novel model derived from qualitative data","volume":"21","author":"Chapman","year":"2022","journal-title":"BMC Palliat Care"},{"key":"B29","article-title":"An exploration of the factors and needs associated with the development of a palliative care programme into the Palestinian healthcare system from different key stakeholders\u2019 perceptions","author":"Abu-Odah","year":"2022"},{"key":"B30","doi-asserted-by":"crossref","DOI":"10.4324\/9781315080369","volume-title":"Hospice and palliative care: the essential guide","author":"Connor","year":"2017"},{"key":"B31","volume-title":"Palliative care needs and outcomes of patients with hepatocellular carcinoma: the case of Uganda Cancer Institute and Mulago National Referral Hospital","author":"Nabachwa","year":"2022"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.02.022","article-title":"Palliative care as an international human right","volume":"33","author":"Brennan","year":"2007","journal-title":"J Pain Symptom Manage"},{"key":"B33","volume-title":"Examining the effects of approaches on reducing hospital utilization: the patient-centred medical home, continuity of care, and the inpatient palliative consultation at the end of life","author":"Sun","year":"2019"},{"key":"B34","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1186\/s12888-025-06889-y","article-title":"Prevalence and factors influencing low social support from family, friends, and significant others among people with mental illness attending psychiatric outpatient clinics in Gondar, Ethiopia","volume":"25","author":"Alemu","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075262","article-title":"Network analysis of mental health problems among adults in Addis Ababa, Ethiopia: a community-based study during the COVID-19 pandemic","volume":"14","author":"Workneh","year":"2024","journal-title":"BMJ Open"},{"key":"B36","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1111\/jns5.12005","article-title":"Association of social support with quality of life in patients with polyneuropathy","volume":"18","author":"Maxwell","year":"2013","journal-title":"J Peripher Nerv Syst"},{"key":"B37","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1186\/s40359-025-02621-3","article-title":"Exploring the impact of interpersonal sensitivity on anxiety symptoms: the mediating role of psychological capital and social support among nursing students","volume":"13","author":"Mi","year":"2025","journal-title":"BMC Psychol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.0164","article-title":"A national strategy for palliative care","volume":"36","author":"Meier","year":"2017","journal-title":"Health Aff (Millwood)"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1177\/26323524231198542","article-title":"Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study","volume":"17","author":"Aregay","year":"2023","journal-title":"Palliat Care Soc Pract"},{"key":"B40","doi-asserted-by":"publisher","first-page":"156","DOI":"10.21203\/rs.3.rs-2581074\/v1","article-title":"Palliative care in Ethiopia\u2019s rural and regional health care settings: a qualitative study of enabling factors and implementation challenges","volume":"22","author":"Aregay","year":"2023","journal-title":"BMC Palliat Care"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1788481\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:38:44Z","timestamp":1776055124000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1788481\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":40,"alternative-id":["10.3389\/fonc.2026.1788481"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1788481","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"1788481"}}