Intersectionality approaches to address health disparities in cancer survivorship care: a systematic scoping review

The use of intersectionality in clinical and research frameworks offers a more multidimensional and holistic approach to the provision of cancer care to those experiencing health disparities. Therefore, we aimed to review the current literature on the use of an intersectionality approach in cancer care for those experiencing cancer health disparities.

We searched four databases, including PubMed, Web of Science, PyscINFO, and Scopus, in November 2024. This scoping review followed the methods and protocol outlined by the Joanna Briggs Institute (JBI) Methods Manual for evidence synthesis.

Of 40 articles included in this review, most (80%, n = 34) employed a quantitative study design, including only three using surveys to collect data. Studies mostly used a retrospective cohort (25%, n = 10) or population-based cohort study design (n = 17) with mostly available datasets. Outcome measures mostly included "mortality" (32.5%, n = 13) and/or "survival" (27.5%, n = 11). However, well-being or quality of life (QOL) and/or its dimensions were measured in a few studies (20%, n = 8). Race and ethnicity are the most investigated identities (92.5%, n = 37) and mostly (n = 28) at the intersection of two or more identities such as socioeconomic status (SES), geographic location, sex/gender, age and their influence on a health outcome in most studies.

There is a need for mixed or qualitative studies to better understand the lived experiences of people who have to navigate through barriers driven by intersecting identities and how they create support or cope with these associated barriers. Future efforts should produce empirical evidence to inform the development and refinement of an intersectionality framework to guide the development of interventions aiming to address the intersecting influence of different identities to improve cancer outcomes.