What are the palliative and end-of-life care needs and preferences of people with cancer from culturally and linguistically diverse (CALD) backgrounds?: A systematic review

Purpose Goal-concordant care is critical to supporting patients at the end of life (EOL), and palliative care is a key facet of this. The study aims to (1) synthesize the evidence available on the EOL and palliative care (PC) needs and preferences of people with cancer from culturally and linguistically diverse (CALD) backgrounds and (2) explore what elements of service provision are facilitators or barriers to service engagement and goal-concordant care. Methods A systematic review was conducted. The search strategy was applied to five electronic databases to identify relevant articles published between January 2003 and September 2025. Quality assessment was performed using the Quality Assessment for Diverse Studies (QuADS) tool. A narrative synthesis was led by one reviewer with the support of a wider team. Results A total of 6017 titles were identified. After duplicate removal and screening, 20 studies were included in the review. Fourteen studies reported EOL care and six reported PC encounters. People from CALD backgrounds identified the following needs: (1) maintaining positivity, (2) maintaining decision-making autonomy, (3) involving family/caregivers in decision-making, and (4) trust in the provider–patient relationship. Factors which influenced patient engagement and care preferences were (1) family involvement, (2) faith/spirituality, and (3) understanding of services. Conclusion This review illustrates the distinct care complexities for patients from CALD backgrounds. These findings underscore the importance of avoiding cultural generalizations and involving consumers in system planning. System-level changes, including community consultation, and improved access to culturally/linguistically appropriate resources are needed to support service engagement.