Determinants of Interest-Holder Perspectives Toward Post-Mortem Tissue Donation in Oncology: A Systematic Review.

Abstract

Objective: Post-mortem tissue donation (PTD) is increasingly recognised as an important resource for advancing cancer research. Developing effective recruitment strategies for PTD programs requires a thorough understanding of interest-holder perspectives, which remain insufficiently explored. This systematic review examined factors influencing patients' willingness to participate in PTD, next-of-kin's willingness to support their relative's participation, and healthcare professionals willingness to recruit for PTD programs.

Methods: A systematic literature search was conducted on 19 February 2026 to identify original research studies exploring self-reported factors influencing perspectives toward PTD. Study selection, data extraction, and quality appraisal were performed independently by four reviewers. Identified factors were synthesised and categorised into five domains: ethical/existential, emotional, practical, socio-demographic/socio-economic, and disease-related.

Results: Fourteen studies were included from 11,986 records screened. Overall, attitudes toward PTD were generally favourable across interest-holders. Ethical, existential and emotional considerations, particularly altruism, reciprocity and the perceived impact on the patient-clinician relationship were associated with willingness to participate in, (support) consent to, or recruit for PTD. Reported barriers were predominantly practical, including logistical challenges, concerns regarding funeral arrangements, and limited knowledge of PTD procedures. Healthcare professionals additionally identified discomfort with end-of-life discussions and uncertainty about PTD processes as barriers to recruitment. Socio-demographic, socio-economic, and disease-related factors were reported inconsistently, with no clear pattern of association.

Conclusions: Interest-holder attitudes toward PTD are primarily shaped by ethical, emotional, and practical considerations. The consistency of findings across interest-holder groups and cancer types supports the development of patient-centred communication strategies to facilitate the implementation of PTD programs.