Abstract A137: Mapping the journey: A scoping review of cancer outcomes in Alabama

Abstract Background Despite almost a century of cancer research that has led to new treatments, advancements in diagnosis, elevated cancer prevention, and improved survivorship, cancer remains the second leading cause of death in Alabama. Further, rates of new cancer diagnoses and mortality in Alabama remain among the highest in the U.S. Yet the rationale for Alabamian cancer disparities is poorly understood. The Robinson and Hudson’s Inter-relationships Framework has been used to model how relationships among patients, cancer burden and healthcare systems impact cancer outcomes in disadvantaged populations. The framework was used to conduct a scoping review to identify how patient, provider, and healthcare system-related factors influence cancer outcomes in Alabama. Methods A PRISMA-guided scoping review was conducted to describe how lifestyle choices, access to healthcare, interventions, cancer burden, risk, quality of life, and other factors may influence health outcomes among Alabama residents. Articles from Embase, MEDLINE, CINAHL, Cochrane/CENTRAL, PsycINFO, and Scopus were evaluated for inclusion. Inclusion criteria were 1) full-text articles, 2) published between 1995 to 2024, and 3) described cancer disparity, risk, treatment and survivorship outcomes within the context of patient, provider, and healthcare systems in Alabama. Articles were independently reviewed by two researchers, with discrepancies mutually reconciled. Included articles were assessed for risk of bias. This project is currently in progress, with data from each article (i.e., study design, purpose, sample, and relevant outcomes) being extracted and synthesized in accordance with the framework. Results Of 1757 articles, 218 were selected for inclusion in the review. Risk of bias among these articles ranked from fair to good. Most articles did not identify cancer outcomes specific to Alabama residents. Articles were published between 1995 and 2025 with the majority published in 2024. The cancers most represented within the articles were breast and colon/colorectal cancers. Further, articles predominantly addressed concepts of cancer risk and preventative health, provider communication, and access to care and resources. Most studies received support from various agencies within the National Institutes of Health (e.g., National Cancer Institute). Preliminary findings suggest this review may highlight how patient (self-efficacy, access to resources, and built environment), provider care (e.g., cultural sensitivity/humility) and healthcare factors (e.g. financial impact and accessible resources) may reduce poor cancer health outcomes. Implications A holistic review of Alabamian cancer outcomes is essential to understand associated problems and how appropriate mitigation strategies can be developed and applied to improve cancer outcomes. Interventions bolstering healthy lifestyle choices, provider readiness to engage diverse patients, and improved navigation to access healthcare resources may yet hold the greatest promise to reducing cancer burden in Alabama. Citation Format: Nicole Caviness-Ashe, Stephen Sodeke, Cha'Breia Means, Miriam Miles, Mackenzie Fowler, Abbie Ninson, LeAndrea Anderson, Lindsay Aaron-Wade, Mary Aboagye, Emma O'Hagan, Oluseun Akinyele, Anita Aboagye, Amnazo Muhirwa, Timiya Nolan. Mapping the journey: A scoping review of cancer outcomes in Alabama abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A137.