Actively engaging multi-level stakeholders in cancer screening and cancer-related studies: a scoping review.

BACKGROUND: There are many stakeholders involved in cancer screening and cancer-related research, including those from the micro, meso, and macro levels. The ways in which stakeholders are engaged are numerous, with some methods being more active than others. There has been limited investigation into which stakeholders are being engaged, how they're being engaged, and if these stakeholders are being engaged together. The aim of this scoping review was to explore methods of active stakeholder engagement with multiple levels of stakeholders in cancer-related studies. METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Articles were included for analysis if they included, at least, two levels of stakeholders who were involved in active stakeholder engagement and originated from the Western countries. There were no restrictions on the date of publication, language, or study design. RESULTS: One hundred and seventy-eight studies met the inclusion criteria. Most articles originated from the United States, were published between 2020 and 17 June 2026, and the topic was not related to any specific cancer type. The micro- and meso-level stakeholder combination was most frequently reported, and 58.4% of studies described stakeholders being engaged together. Interviews, focus groups, and committees were the most commonly reported engagement activities. CONCLUSIONS: Macro-level stakeholders may not be engaged due to the possibility of power imbalances with micro- and meso-level stakeholders. There was great variation in the way stakeholder engagement activities were described, highlighting a need to negotiate terminology.