Cancer Burden in Persistent Poverty Areas across the Cancer Continuum: A Scoping Review to Identify Gaps and Opportunities for Future Research

There is a growing understanding of the influence of long-term place-based poverty, termed persistent poverty, on cancer outcomes. The goal of this scoping review was to characterize the rapidly growing body of literature on the relationship between persistent poverty and outcomes across the cancer care continuum while identifying gaps and opportunities for future research. We searched the CINAHL, Embase, PubMed MEDLINE, and Web of Science databases. Inclusion criteria were peer-reviewed journal articles in English with empirical data from studies conducted in the United States that described cancer outcomes in persistent poverty area(s) and/or compared cancer outcomes in persistent poverty area(s) to other areas. The search yielded 35 articles that were retained for data extraction. Cancer mortality was the most frequently studied outcome; other outcomes assessed were development (including incidence and stage at diagnosis), risk reduction, early detection, treatment, and survivorship (including palliative end-of-life care). Overwhelmingly, persistent poverty residence was associated with worse outcomes across the cancer continuum. Rurality and race intersected with persistent poverty to influence cancer outcomes. Interventions are urgently needed to address the factors contributing to the high cancer burden in persistent poverty areas.