A scoping review of interventions, services, and models of care to improve access to cancer treatment for adults who are socially disadvantaged Show others and affiliations
2026 (English) In: SSM - Health Systems, ISSN 2949-8562, Vol. 7, article id 100238Article in journal (Refereed) Published
Abstract [en]
Background Timely and equitable access to cancer treatment are important markers of the quality and accessibility of cancer care, yet socially disadvantaged people experience a range of barriers to receiving cancer treatment, significantly impacting cancer outcomes, including survival and quality of life. However, interventions designed to improve treatment access for these populations have not been comprehensively mapped. This scoping review aimed to identify and summarize interventions, services, and models of care intended to improve access to cancer treatment among socially disadvantaged groups. Methods We conducted a scoping review to identify and summarize interventions designed to improve access to cancer treatment for people experiencing varying forms of social disadvantage. MEDLINE, EMBASE, and CINAHL were searched for relevant studies published before 2025. Data on study characteristics, intervention types, targeted barriers, and outcomes related to treatment access were extracted and synthesized descriptively. A formal risk-of-bias assessment was not conducted, consistent with scoping review methodology. Findings A total of 57 studies met the inclusion criteria, with nearly half published since 2020. Most studies were conducted in the United States (56) and used observational designs. Interventions addressed various treatment modalities, most commonly surgical treatment (37%), followed by radiotherapy and systemic therapy. Policy-focused interventions, particularly Medicaid expansion, were most frequently evaluated, followed by patient navigation programs. Education-based interventions were relatively few (7%). Institutional and system-level interventions showed more consistent improvements in treatment access. The barriers most commonly targeted included insurance coverage, financial constraints, and transportation. Conclusions Most interventions focused on financial or insurance-related disadvantage, highlighting gaps in evidence-informed strategies addressing other forms of social disadvantage. The predominance of U.S.-based studies also indicates a need for evidence on effective interventions in other health system contexts.
Place, publisher, year, edition, pages Elsevier BV , 2026. Vol. 7, article id 100238
Keywords [en]
Cancer services, Health equity [MeSH], Health services accessibility [MeSH], Health services research [MeSH], Vulnerable populations [MeSH]
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health and Social Medicine Cancer and Oncology
Identifiers URN: urn:nbn:se:mdh:diva-79070 DOI: 10.1016/j.ssmhs.2026.100238 Scopus ID: 2-s2.0-105050556510 OAI: oai:DiVA.org:mdh-79070 DiVA, id: diva2:2104313
2026-09-232026-09-232026-09-23 Bibliographically approved