Principles to promote social equality across the cancer trajectory: A group concept mapping study

BACKGROUND AND PURPOSE: Social inequality is a growing problem throughout the cancer trajectory. Since 2019, the Danish Research Center for Equality in Cancer (COMPAS) has therefore, through seven work packages developed and tested various methodologies, approaches, and interventions to promote social equality in cancer from diagnosis to end of life. This study aimed to synthesize the knowledge generated across the work packages to provide guiding principles for promoting social equity across the cancer trajectory. MATERIAL AND METHODS: A group concept mapping study was conducted in Denmark between February and June 2023. Twenty-two employees from all COMPAS work packages brainstormed ideas on how to promote social equality across the cancer trajectory. Fourteen participants subsequently sorted and rated the ideas by importance. Multidimensional scaling analysis and hierarchical cluster analysis were used to generate a cluster rating map outlining principles for promoting social equality in cancer. These principles were validated by 10 participants during an in-person validation meeting. Discussions from both the brainstorming and validation meeting were recorded, transcribed verbatim, and analysed. RESULTS: Eight principles comprising 162 ideas were identified. Four principles focused on the patient-provider level: (1) Person-centred approach, (2) Supportive interventions targeting vulnerable patients, (3) Communication, and (4) Screening for vulnerability. Four addressed the organizational and policy level: (5) Skills development and implementation, (6) Coherence across, (7) Organizational and cultural factors, and (8) Transportation and accessibility. INTERPRETATION: Integrating these principles into future research and clinical practice may support efforts to reduce social inequities across the cancer trajectory.