Time-Toxicity Indicators and Mitigation Strategies in Cancer Care: A Scoping Review

To map strategies for mitigating time toxicity in cancer care, summarize time-toxicity-related indicators, and identify implications for nursing and supportive care.

This scoping review was conducted in accordance with Joanna Briggs Institute guidance and reported using the PRISMA-ScR checklist. The PCC framework was used to define the population, concept, and context. PubMed, Embase, CINAHL, and Web of Science were searched from inception to June 1, 2026. Eligible studies were peer-reviewed empirical studies involving patients with cancer or cancer survivors and reporting time-toxicity-related indicators or strategies relevant to reducing time burden in cancer care. Two reviewers independently screened records and charted data using a standardized form.

Fifteen studies published between 2017 and 2026 were included. Study populations covered breast, prostate, gynecologic, gastrointestinal, hepatocellular, hematologic, and mixed cancer populations. Indicators included travel distance, travel time, waiting time, total encounter time, health care contact days, days at home, hospital days, emergency department days, treatment visits, overall treatment time, and transfusion-related time burden. Four strategy domains were identified: decentralized and closer-to-home care, digital support and workflow optimization, individualized scheduling and logistical support, and optimization of treatment-related time burden. These strategies addressed time burden by reducing travel, shortening waiting or encounter time, improving logistical support, optimizing treatment pathways, or incorporating time costs into treatment decision-making.

Time toxicity arises from treatment and from how patients access, receive, coordinate, and manage cancer care. Current evidence identifies potential mitigation directions but does not establish comparative effectiveness. Future studies should develop consistent core measures and prospectively evaluate mitigation strategies. Nursing practice, education, and policy should recognize time burden as part of patient-centred cancer care and care pathway design.