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Marginalized patient identities and the patient-physician relationship in the cancer care context: a systematic scoping review

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Abstract

Purpose

We sought to examine and categorize the current evidence on patient-physician relationships among marginalized patient populations within the context of cancer care using a systemic scoping review approach.

Methods

Web-based discovery services (e.g., Google Scholar) and discipline-specific databases (e.g., PubMed) were queried for articles on the patient-physician relationship among marginalized cancer patients. The marginalized populations of interest included (1) race and ethnicity, (2) gender, (3) sexual orientation and gender identity, (4) age, (5) disability, (6) socioeconomic status, and (7) geography (rural/urban). Study screening and data extraction were facilitated through the Covidence software platform.

Results

Of the 397 screened studies, 37 met study criteria—most articles utilized quantitative methodologies (n = 28). The majority of studies focused on racial and ethnic cancer disparities (n = 27) with breast cancer (n = 20) as the most common cancer site. Trust and satisfaction with the provider were the most prevalent issues cited in the patient-physician relationship. Differences in patient-physician communication practices and quality were also frequently discussed. Overall, studies highlighted the need for increased culturally congruent care among providers.

Conclusion

Results from this review suggest marginalized cancer patients face significant barriers in establishing culturally and linguistically congruent patient-physician relationships. Future studies should focus on the intersectionality of multiple marginalized identities and optimization of the patient-physician relationship.

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Authors and Affiliations

  1. Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA

    Elizabeth Palmer Kelly

  2. The Ohio State University, Columbus, OH, USA

    Julia McGee

  3. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Samilia Obeng-Gyasi, Rosevine Azap, Alizeh Abbas & Timothy M. Pawlik

  4. Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA

    Chelsea Herbert

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Contributions

Elizabeth Palmer Kelly and Julia McGee developed the original idea for the current review. Elizabeth Palmer Kelly, Julia McGee, Chelsea Herbert, Rosevine Azap, and Alizeh Abbas undertook the literature search, data extraction, and data consolidation processes. All authors contributed to the drafting and editing the manuscript. Samilia Obeng-Gyasi and Timothy Pawlik critically revised the manuscript drafts.

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Correspondence to Timothy M. Pawlik.

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Elizabeth Palmer Kelly and Julia McGee are co-first authors

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Palmer Kelly, E., McGee, J., Obeng-Gyasi, S. et al. Marginalized patient identities and the patient-physician relationship in the cancer care context: a systematic scoping review. Support Care Cancer 29, 7195–7207 (2021). https://doi.org/10.1007/s00520-021-06382-8

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