Unmet Support Needs in Cancer Navigation for Diverse Populations in Canada and the United States

Patient navigation programs are widely used to improve cancer care delivery, particularly among underserved populations. However, gaps remain in understanding which support needs are most frequently reported and whether high-risk populations are adequately represented. This scoping review examined how patient support needs are documented in cancer navigation studies and which populations are evaluated.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we reviewed articles published between January 2014 and December 2024. PubMed, Web of Science, and CINAHL Ultimate were searched for US and Canadian studies evaluating navigation or support interventions for breast, colorectal, prostate, lung, or general cancers. Eligible studies reported empirical data and addressed patient or provider perspectives on support needs. Extracted data included demographic representation, geographic location, cancer type, and unmet support needs.

Of the 1,254 records identified, 25 studies met inclusion criteria. Lung cancer was the most frequently studied (60%), and most studies were conducted on the US West Coast. Although 84% of studies included patient perspectives, only 36% reported geographic setting and 12% included income data. Asian and Pacific Islander (48%), White (44%), and Hispanic/Latino (36%) populations were most represented. African American and American Indian or Alaska Native populations were underrepresented at 20% and 12%, respectively. Common support needs included communication challenges (72%), emotional support (64%), limited access to care (60%), and educational gaps (60%). Cultural competence and trust were each reported in only 24% of studies.

This review reveals a mismatch between populations most affected by cancer disparities and those represented in navigation research. Future studies should prioritize inclusive data collection, improved demographic reporting, and patient-centered design of support services to address persistent inequities.