Digital oncology interventions and equity: a scoping review of design strategies to address cancer disparities.

BACKGROUND

Digital health interventions have transformed oncology care delivery, yet their capacity to exacerbate or mitigate cancer disparities remains insufficiently understood. This scoping review examined equity dimensions of digital oncology interventions, mapping the evidence on design strategies, access barriers, and inclusion approaches across the cancer care continuum.

METHODS

Following the PRISMA-ScR guidelines and Arksey and O'Malley's framework, we searched PubMed and Scopus for studies published from January 2012 to 2025. Studies examining digital oncology interventions with explicit or implicit equity, access, or inclusion components were eligible. Data were synthesised using descriptive numerical summaries and narrative thematic synthesis, with equity dimensions conceptualised across access, population, and systemic domains.

RESULTS

Thirty-three studies met the inclusion criteria. Publication volume accelerated markedly from 2021 onwards, with 36% of studies published in 2025, though this concentration may partly reflect temporal proximity to the search date. Research was concentrated in high-income countries, with 79% of randomised controlled trials conducted in urban settings. Interventions included telemedicine platforms, mHealth applications, patient portals, and remote monitoring systems. Technical barriers were pervasive, with a striking proportion of lung cancer screening participants lacking home internet access in one population-level study-a data point that itself underscores the scarcity of such evidence. Equity-enhancing strategies included read-aloud functions, culturally adapted content, community health worker support, and behavioural design principles. Digital nudge interventions increased screening adherence (OR = 1.81; 95% CI 1.35-2.44), though higher education and employment were consistently associated with better uptake.

CONCLUSION

Digital oncology interventions hold considerable promise, but equitable benefit demands deliberate attention to design, implementation, and evaluation. Geographic, population, and methodological gaps persist. Future research should prioritise underserved settings, standardised equity measurement, and scalable inclusion strategies.