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. 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. 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. 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.
Horrill et al. (Fri,) studied this question.