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Prevalence of Food Insecurity Among Cancer Survivors in the United States: A Scoping Review

      Abstract

      Background

      Medical financial hardship is an increasingly common consequence of cancer treatment and can lead to food insecurity. However, food security status is not routinely assessed in the health care setting, and the prevalence of food insecurity among cancer survivors is unknown.

      Objective

      This scoping review aimed to identify the prevalence of food insecurity among cancer survivors in the United States before the COVID-19 pandemic.

      Methods

      Five databases (PubMed, Scopus, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Web of Science, and ProQuest Dissertations and Theses) were systematically searched for articles that reported on food security status among US patients receiving active cancer treatment or longer-term cancer survivors and were published between January 2015 and December 2020.

      Results

      Among the 15 articles meeting the inclusion criteria, overall food insecurity prevalence ranged from 4.0% among women presenting to a gynecologic oncology clinic to 83.6% among patients at Federally Qualified Health Centers. Excluding studies focused specifically on Federally Qualified Health Center patients, prevalence of food insecurity ranged from 4.0% to 26.2%, which overlaps the food insecurity prevalence in the general US population during the same time period (range, 10.5% to 14.9%). Women were more likely than men to report being food insecure, and the prevalence of food insecurity was higher among Hispanic and Black patients compared with non-Hispanic White patients.

      Conclusions

      Given significant heterogeneity in study populations and sample sizes, it was not possible to estimate an overall food insecurity prevalence among cancer survivors in the United States. Routine surveillance of food security status and other social determinants of health is needed to better detect and address these issues.

      Keywords

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      Biography

      K. Robien is an associate professor, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health and GW Cancer Center, George Washington University, Washington, DC.

      Biography

      M. Clausen is a doctoral candidate, School of Nursing, George Washington University, Washington, DC.

      Biography

      E. Sullo is a manager, Medical Library at Lee Health, Fort Myers, FL; at the time of the study, she was a librarian, Himmelfarb Health Sciences Library, George Washington University, Washington, DC.

      Biography

      Y. R. Ford is an assistant professor, School of Nursing, North Carolina A&T State University, Greensboro.

      Biography

      K. A. Griffith is an associate professor, School of Nursing and GW Cancer Center, George Washington University, Washington, DC.

      Biography

      D. Le is an assistant professor, School of Nursing and GW Cancer Center, George Washington University, Washington, DC.

      Biography

      K. E. Wickersham is an assistant professor, College of Nursing, University of South Carolina, Columbia.

      Biography

      S. Flynt Wallington is an assistant professor, School of Nursing and GW Cancer Center, George Washington University, Washington, DC.