Exploring Primary Care Interventions to Increase Lung, Breast, and Cervical Cancer Screening With Individuals Experiencing Marginalization: A Scoping Review.

IntroductionScreening for lung, breast, and cervical cancer can reduce morbidity and mortality by enabling earlier detection and treatment. However, participation remains below target levels, particularly among individuals experiencing marginalization. While primary care providers (PCPs) can play a key role in improving screening uptake, few reviews have focused on interventions targeting individuals experiencing marginalization that are aimed at PCPs, delivered by PCPs, or that occurred in a primary care setting.MethodsThe aim of this scoping review was to examine the extent and types of PCP interventions implemented to increase lung, breast, and cervical cancer screening uptake among individuals experiencing marginalization and identify gaps to inform future practice and research. We searched for studies of PCP interventions aimed at increasing lung, cervical, and/or breast cancer screening among marginalized populations in Ovid MEDLINE, Ovid Embase, Scopus, EBSCO CINAHL Complete and Ovid EBM Reviews - Cochrane Central Register of Controlled Trials from 2000 to March 31, 2022. Title, abstract, and full-text articles were screened, and data extraction was performed by three independent reviewers. The charted data were summarized using narrative synthesis.ResultsForty-two studies were included: 13 for cervical cancer, 15 for breast cancer, one for lung cancer, and 13 on multiple cancer sites. Interventions included education (for both patients and PCPs), self-collected human papillomavirus (HPV) testing, patient navigation, clinic system tools, event-based, and multicomponent. Increases in screening rates were observed across various intervention types for breast and cervical cancer, with multi-site interventions evaluated based on their reported effects on breast and cervical cancer screening independently.ConclusionsEducational interventions demonstrated the greatest effectiveness for breast cancer screening, and self-collected HPV testing demonstrated the greatest effectiveness for cervical cancer screening. There is a clear gap in the literature regarding interventions aimed at increasing lung cancer screening participation, and further research is needed to evaluate the effectiveness of such interventions. Screening programs and PCPs should consider targeted strategies to support greater participation among individuals experiencing marginalization.