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

Kim Robien; Michelle Clausen; Elaine Sullo; Yvonne R Ford; Kathleen A Griffith; Daisy Le; Karen E Wickersham; Sherrie Flynt Wallington

doi:10.1016/j.jand.2022.07.004

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

J Acad Nutr Diet. 2023 Feb;123(2):330-346. doi: 10.1016/j.jand.2022.07.004. Epub 2022 Jul 12.

Authors

Kim Robien¹, Michelle Clausen², Elaine Sullo³, Yvonne R Ford⁴, Kathleen A Griffith⁵, Daisy Le⁵, Karen E Wickersham⁶, Sherrie Flynt Wallington⁵

Affiliations

¹ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC; GW Cancer Center, George Washington University, Washington, DC. Electronic address: krobien@gwu.edu.
² School of Nursing, George Washington University, Washington, DC.
³ Himmelfarb Health Sciences Library, George Washington University, Washington, DC.
⁴ School of Nursing, North Carolina A&T State University, Greensboro, NC.
⁵ GW Cancer Center, George Washington University, Washington, DC; School of Nursing, George Washington University, Washington, DC.
⁶ College of Nursing, University of South Carolina, Columbia, SC.

PMID: 35840079
DOI: 10.1016/j.jand.2022.07.004

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: Cancer; Financial hardship; Food security; Social determinants of health; Supportive care.

Publication types

Review

MeSH terms

COVID-19*
Cancer Survivors*
Female
Food Insecurity
Food Supply
Genital Neoplasms, Female*
Humans
Male
Pandemics
Prevalence
United States / epidemiology