Shared Decision-Making in US Cancer Care: A Scoping Review

Shared decision-making (SDM) has emerged as a gold standard in cancer care, with the growing development of interventions to support it. However, SDM remains suboptimal due to inconsistent definitions and measurements with various implementation challenges.

This scoping review aims to map the literature on SDM in cancer care within the United States, focusing on how it is defined, implemented, measured, and evaluated.

Arksey and O'Malley's methodology was used. We included research conducted in the United States involving patients with cancer in SDM. PubMed, CINAHL, Web of Science, and Embase were searched in December 2023, with an updated search conducted in May 2025, for studies published in English between 2018 and 2024.

From the initial 1259 articles, 20 studies were included, revealing inconsistency in how SDM was defined and operationalized. In particular, family caregivers were inconsistently recognized as stakeholders. Although most studies reported using tools to support SDM, these varied in format and clinical context, while measurement approaches differed across studies, with a lack of standardization limiting comparability. Research was also disproportionately concentrated on specific types of cancer and academic settings.

This review highlights persistent gaps in the concept, from inconsistent definitions to varied measurement practices, and limited scope across settings. Findings indicate the need for advanced nursing research to standardize SDM definitions and broaden its implementation.

SDM in oncology remains challenging. Addressing identified gaps is important to advancing equitable, comprehensive, and patient-centered cancer care decision-making.