<p>Clinical characteristics of patients (N = 170).</p>

Introduction The increasing burden of cancer in resource-limited settings like Uganda puts pressure on healthcare systems and leaves many patients’ needs unmet. These unmet needs impact service uptake, perceptions of care, and health outcomes. However, the extent and effect of unmet care needs on patients’ health outcomes remain poorly characterised. Methods A cross-sectional study involved 170 adult cancer patients at the Uganda Cancer Institute (UCI). Participants filled out validated instruments such as the Hospital Anxiety and Depression scale (HADS), the EORTC QLQ-30 (Quality of life scale) and the Supportive Care Needs Survey (SCNS-SF34). Descriptive statistics, correlation and regression analyses examined the relationship between unmet needs and health outcomes. Results Nearly half (45.9%) of participants reported clinically significant anxiety symptoms, while 35.9% had depressive symptoms. The highest unmet needs were in physical/daily living (mean = 73.59 ± 20.26), psychological (51.77 ± 18.24), and health system/information domains (38.96 ± 19.59). Poor quality of life was observed in role (18.14 ± 27.01) and social functioning (9.41 ± 18.48). Fatigue (β = 0.23, p < 0.01) and anxiety (β = 0.20, p < 0.01) were the strongest predictors of overall unmet needs. Conclusion Cancer patients in Uganda experience substantial unmet needs, particularly in physical, psychological, and informational support, which are strongly linked to worse mental health and quality of life. To improve patient outcomes, integrated interventions targeting symptom management, psychosocial support, and health system strengthening are urgently needed.