Synthesis of Existent Oncology Curricula for Primary Care Providers: A Scoping Review With a Global Equity Lens

Abstract

Purpose: Global increases in cancer, coupled with a shortage of cancer specialists, has led to an increasing role for primary care providers (PCP) in cancer care. This review aimed to examine all extant cancer curricula for PCPs and to analyze the motivations for curriculum development.

Methods: A comprehensive literature search was conducted from inception to October 13, 2021, with no language restrictions. The initial search yielded 11,162 articles and 10,902 articles underwent title and abstract review. After full-text review, 139 articles were included. Numeric and thematic analyses were conducted and education programs were evaluated using Bloom's taxonomy.

Results: Most curricula were developed in high-income countries (HICs), with 58% in the United States. Cancer-specific curricula focused on HIC priority cancers, such as skin/melanoma, and did not represent the global cancer burden. Most (80%) curricula were developed for staff physicians and 73% focused on cancer screening. More than half (57%) of programs were delivered in person, with a shift toward online delivery over time. Less than half (46%) of programs were codeveloped with PCPs and 34% did not involve PCPs in the program design and development. Curricula were primarily developed to improve cancer knowledge, and 72 studies assessed multiple outcome measures. No studies included the top two levels of Bloom's taxonomy of learning (evaluating; creating).

Conclusion: To our knowledge, this is the first review to assess the current state of cancer curricula for PCPs with a global focus. This review shows that extant curricula are primarily developed in HICs, do not represent the global cancer burden, and focus on cancer screening. This review lays a foundation to advance the cocreation of curricula that are aligned to the global cancer burden.

FIG 1

PRISMA diagram. IMG, image; PCP, primary care provider; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

FIG 2

Country of origin. Global map showing the countries that developed >5 curricula (dark blue) and <5 curricula (medium blue). Countries in light blue did not develop curricula included in this review.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.

FIG A1

Study overview (N = 139). List of studies included in this review, sorted in alphabetical order by Tx followed by country. Tx is in grayscale and in the following order: active treatment, multiple, prevention, screening, survivorship, and unspecified. ABCDE, ABCDE’s of melanoma; OBGYN, obstetrics and gynecology; PSA, prostate-specific antigen; TADA, triage amalgamated dermoscopic algorithm; Tx, treatment focus.