Evidence base for patient portal use among underserved populations in cancer care: A scoping review.

288 Background: Patient portals have been associated with improvements in medication adherence, preventive care, disease awareness, self-management, satisfaction, and patient-provider communication. Prior research suggests that patient portals may support cancer care and offer particular benefits for underserved populations; however, their use across the cancer care continuum in these groups remains underexplored. Methods: We conducted a scoping review to examine the use of patient portals in cancer care among underserved populations, following the framework outlined by Arksey and O’Malley. A comprehensive search of PubMed, Scopus, and Web of Science was performed using medical subject headings and keywords related to cancer, patient portals, and underserved populations. Eligible studies were peer-reviewed, published in English, conducted in the United States, and used quantitative or qualitative methods to examine patient portal use in the context of cancer care. Data were extracted on study design, cancer type, underserved population examined, portal technology and intervention features, methodological approach, sample size, and key findings. We conducted a thematic analysis using the inductive-deductive approach described by Clarke and Braun. Results: The search yielded 198 articles, of which 25 met inclusion criteria. Studies addressed diverse underserved groups, including racial and ethnic minorities, individuals with limited digital literacy, low-income populations, and rural residents. Four major themes emerged: (a) racial and ethnic disparities in portal access and use; (b) benefits of portal features, including secure messaging, PRO collection, care coordination, and telehealth integration; (c) user and provider preferences and needs, such as language options, feature awareness, formatting of information, and modality choices; (d) barriers to access and use, including limited internet or device access, low technology comfort, and insufficient support for onboarding or navigation; and (e) use of real-world data to evaluate portal engagement, implementation strategies, and automated outreach. Conclusions: This review highlights a growing but still limited body of research on patient portal use among underserved populations in cancer care. Findings underscore the importance of addressing disparities, aligning portal features with user preferences, and mitigating access barriers.