Describing the Core Attributes and Impact of Comprehensive Cancer Centers Internationally: A Chronological Scoping Review.

Abstract

Background/Objectives: Comprehensive cancer centers (CCCs) remain at the forefront of cancer control efforts. Limited clarity and variation exist around the models, scope, characteristics, and impacts of CCCs around the globe. This scoping review systematically searched and synthesized the international literature, describing core attributes and anticipated and realized impacts of CCCs, detailing changes over time. Methods: Searches for English language sources were conducted across PubMed, Cochrane CENTRAL, Epistemonikos, and the gray literature from January 2002 to April 2024. Data were extracted and appraised by two authors. Results were narratively synthesized. Results: Of 3895 database records and 843 gray literature sources screened, 81 sources were included. Papers were predominantly opinion-based, from the USA and Europe, and published between 2011 and 2020. Internationally, the interconnected attributes of CCCs included (1) clinical service provision; (2) research, data, and innovation; (3) education and clinical support; (4) networks and leadership; (5) health equity and inclusiveness; and (6) accountability and governance. Largely anticipated impacts were synergistic and included delivery of optimal, person-centered, complex care; development of a highly qualified cancer workforce; greater research activity and funding; effective, strategic alliances; and reduction in cancer-related inequalities. Limited evidence was found demonstrating measurable broad outcomes of CCCs. The early literature highlighted the establishment, development, and accreditation of CCCs. The ongoing literature has reflected the evolution of cancer care, key areas for growth, and limitations of CCCs. Recently, the CCC literature has increased exponentially and focused on the need for CCCs to drive networks and leadership to address health equity and inclusiveness. Conclusions: Results suggest that CCCs are yet to reach their full potential, with future efforts ideally focusing on accountability, effective networking, and health equity at a local, national, and international level. CCCs must generate evidence of impact, and continue to evolve in line with contemporary healthcare, to fulfil their role in cancer control efforts.