Community governance and nutrition-oriented cancer care for women: policy pathways to reduce survival disparities

Nutrition is increasingly recognized as a modifiable determinant of treatment tolerance, metabolic health, quality of life, and survivorship outcomes among women with cancer. However, nutrition-oriented cancer care is often delivered as an individual-level clinical recommendation, while many determinants of dietary behavior and nutritional vulnerability arise outside oncology clinics. Food insecurity, unequal food environments, limited dietitian availability, fragmented referral systems, low nutrition literacy, transport barriers, and gendered caregiving roles can prevent women with breast, cervical, ovarian, endometrial, and other cancers from receiving timely and effective nutrition support. Community governance provides a policy framework for linking oncology services with primary care, public health agencies, community organizations, food assistance programs, digital platforms, and patient groups. This Mini Review examines how community governance can strengthen nutrition-oriented cancer care for women and reduce survival disparities. We summarize pathways through which community-level conditions influence nutritional status and survivorship, distinguish established evidence from promising implementation models and expert-policy rationale, and propose governance mechanisms for nutrition screening, referral, food support, and follow-up. Community-governed nutrition care should move beyond service volume and evaluate whether nutritionally vulnerable women receive accessible, culturally appropriate, and outcome-oriented support across the cancer continuum.