Cancer care barriers and interventions among immigrant workers: an evidence map and practice-oriented review

Immigrant workers represent a distinct oncology equity population because cancer care barriers occur at the intersection of migration status, occupational precarity, language access, fragmented insurance eligibility, legal vulnerability, income loss, and limited paid leave. Oncology literature rarely characterizes immigrant workers as a distinct analytic group.

To map direct, partial, and indirect evidence on cancer care barriers and interventions relevant to immigrant workers and translate the findings into evidence-supported implications, evidence-informed adaptations, and research or policy directions.

We conducted a modified, practice-oriented evidence map using 48 sources identified through targeted database, citation, and policy-source searching. Sources were charted by population, immigrant-worker specificity, source type, primary analytic domain, cancer continuum stage, barrier or intervention focus, key contribution, and evidence gap.

Of 48 mapped sources, 1 was direct, 8 were partial, and 39 were indirect evidence. The source set comprised 20 empirical studies, 17 evidence syntheses, 9 government, policy, or legal sources, and 2 commentaries or methods papers. Evidence was concentrated in structural and policy access, screening and navigation, and language and communication; evidence remained sparse for work-related treatment interruption, survivorship and return to work, employer interventions, and clinical trial access. Professional interpretation, language-concordant communication, patient navigation, community health worker outreach, culturally tailored screening, and community-based participatory approaches had the clearest support in adjacent or broader immigrant populations. Flexible scheduling, bundled visits, workplace protections, and structured return-to-work support were research or policy priorities requiring evaluation.

Immigrant workers are a structurally vulnerable oncology population shaped by overlapping employment, legal, linguistic, financial, and health-system barriers. Oncology systems can implement supported language-access and navigation strategies while testing worker-adapted delivery models and advocating for policy changes that reduce coverage and employment-related barriers.