Cancer Care Interventions Among Global Refugee Populations: A Scoping Review Restricted; Files Only

Nur, Nushrat (Spring 2023)

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Background: Noncommunicable diseases (NCDs) are responsible for 74% of deaths worldwide, despite being preventable. Cancer is the second leading cause of mortality globally, with refugee populations suffering through delayed diagnoses and treatment, leading to higher prevalence of advanced-stage cancer and poorer prognosis.

Objectives: This scoping review aims to provide a comprehensive investigation and assessment of the status of cancer care among refugee populations around the world using the socioecological model as framework for analysis.  An assessment of gaps and areas for improvement will be discussed as well as recommendations to address them.

Methods: This scoping review developed eligibility criteria through the Participants, Interventions, Comparators, Outcomes (PICO) model. Studies were restricted to English language only, placed between the years 2000-2023 and focused on current existing primary, secondary and tertiary interventions or models of care and then information was extracted and assigned to the various levels of the socioecological model.

Results: The interventions were mainly health promotion and cancer awareness interventions that sought to increase knowledge and improve screening practice and behavior. The main cancer types that were investigated were breast and cervical cancer among refugee women. Tertiary prevention such as palliative care and more treatment based interventions were lacking from the literature. Culturally tailored patient navigation and faith based frameworks continued to be a crucial element of intervention planning and implementation. Mobile cancer care and virtual education programs showed a lot of promise to guide future interventions. Structural policy changes to protect refugees as they sought cancer care were lacking in the literature.

Conclusion: This scoping review looked to identify current cancer care interventions among the global refugee population and assess them according to the socioecological model to determine gaps in the literature. This paper can be used as a starting point to inform and guide future interventions for refugee cancer care across all contexts.

Table of Contents

Chapter 1: Introduction 1

Background 1

Statement of Problem 2

Statement of Purpose 3

Statement of Significance 3

References 4

Chapter 2: Literature Review 6

Non-communicable Diseases and Displacement 6

Cancer Care in Refugee Populations 7

References 13

Chapter 3: Manuscript 16

Abstract 16

Background 17

Methods 18

Results 20

Discussion 32

Conclusion 37

References 38

Tables and Figures 44

Chapter 4: Discussion and Recommendations 51

Discussion 51

Recommendations 55

References 57

Appendix 58

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