How and Under What Conditions Do Patient Portals Improve Cancer Screening Completion: A Scoping Review.

Area of Science:

• Health Services Research
• Digital Health
• Cancer Prevention

Background:

• Patient portals are increasingly used to facilitate healthcare access and patient engagement.
• Evidence suggests patient portals can improve cancer screening rates, yet the underlying mechanisms require further elucidation.
• Understanding these mechanisms is crucial for optimizing digital health strategies in cancer care.

Purpose of the Study:

• To conduct a scoping review of influencing factors that explain how patient portals increase cancer screening.
• To inform the development of causal pathway diagrams illustrating the relationship between patient portals and cancer screening.
• To identify research gaps in understanding the mechanisms and moderators of patient portal effectiveness in cancer screening.

Main Methods:

• A systematic search of PubMed was conducted for U.S. studies published between 2014 and 2024.
• Studies focused on average-risk patients and interventions/evaluations of patient portals for breast, cervical, colorectal, or lung cancer screening.
• Data extraction and synthesis were performed by two authors to develop causal pathway diagrams.

Main Results:

• Thirty-two studies met the inclusion criteria, with most focusing on breast or colorectal cancer screening.
• A majority of studies (18 of 21) found that patient portals were associated with increased cancer screening.
• Key influencing factors identified included provider recommendation for self-scheduling (moderator), and patient activation and cancer worry/fatalism (mechanisms).

Conclusions:

• While patient portals show promise in increasing cancer screening, few studies have directly tested the proposed influencing factors.
• A significant research gap exists in empirically validating the mechanisms through which patient portals enhance cancer screening.
• Further research is needed to refine causal pathway diagrams and optimize the implementation of patient portals for cancer screening interventions.