Background: Colorectal cancer (CRC) is one of the most common cancers worldwide, and increasing survival rates have resulted in a growing population of survivors. Vietnam is no exception, with a rising number of CRC survivors placing a burden on the country' s healthcare system. Understanding the unmet supportive care needs of CRC survivors in Vietnam is critical, as most existing research focuses on Western contexts and may not generalize to the country's unique healthcare and cultural environment.
Purpose: This study aimed to (1) identify the unmet supportive care needs among CRC survivors in Vietnam, (2) examine the factors associated with these unmet needs, and (3) explore the relationship between these unmet needs and psychological distress.
Methods: A quantitative cross-sectional design with convenience sampling was conducted at Vietnam National Cancer Hospital from April to July 2025. Eligible participants were adults (≥18 years old) who had been diagnosed with CRC, had completed primary treatment, and were attending regular follow-up visits. Exclusion criteria included stage IV disease, CRC recurrence or metastasis, other cancers along with CRC, cognitive impairment, or a history of mental illness. The questionnaire included a personal information form, the Cancer Survivors' Unmet Needs (CaSUN) measure, and the Hospital Anxiety and Depression Scale (HADS). Descriptive analyses, simple linear regression, and hierarchical regression were used to analyze the data with a significance level of p < .05.
Results: A total of 354 CRC survivors were enrolled in the study. Most participants (70.8%) reported at least one unmet need. The mean prevalence score of unmet needs was 6.66 out of 35 (SD = 6.34), and the mean intensity score of unmet needs was 0.26 out of 3 (SD = 0.29). Participants reported the highest frequency of unmet needs in the existential survivorship domain and the most severity in the quality-of-life domain. Factors related to higher unmet need included younger age, lower education, employment, lower income, stage III cancer, receipt of adjuvant therapy, and a shorter duration since treatment completion. Regarding psychological distress, 29.7% of participants experienced clinical levels of anxiety, whereas a substantially higher proportion (61.6%) met the criteria for clinical depression. The prevalence of unmet needs was significantly higher among participants with psychological distress compared to those without distress (p < .001). After adjusting for confounders, unmet needs independently predicted psychological distress, as higher levels of unmet needs were significantly associated with greater anxiety or depression (p < .001).
Conclusion: CRC survivors face a broad spectrum of unmet needs that differ in prevalence and intensity, underscoring the necessity of regular assessment during follow-up care. These unmet needs are closely linked to increased psychological distress, highlighting the importance of tailored supportive care that directly addresses them to reduce survivors' distress. Future research should adopt longitudinal and qualitative approaches to capture the dynamic changes in unmet needs and psychological distress over time, along with the nuanced experiences of CRC survivors to inform more responsive supportive care strategies.

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